妊娠期肝内胆汁淤积症患者脐血瘦素水平及临床意义

目的探讨ICP患者脐血瘦素水平的变化及其临床意义。方法随机选取住院病人42例,其中ICP孕妇30例和正常孕妇12例,ICP患者按不同分度、不同孕周及羊水胎粪污染有无分类。采用放射免疫法检测脐静脉血瘦素水平。数据用SPSS16.0统计软件分析。结果（1）15例轻度ICP组、15例重度ICP组与正常组的脐血瘦素水平,三组比较无明显差异（P〉0.05）。正常组脐血瘦素水平与新生儿体重呈明显正相关（r=0.678、P=0.015）,但ICP组无相关性（P〉0.05）。（2）ICP早产组17例、足月产组13例,ICP足月产组脐血瘦素水平较其早产组、正常组增高,差异有显著性（P〈0.05）。ICP早产组与正常组比较无显著差异（P〉0.05）。正常组、ICP组的脐血瘦素水平与各不同孕周无相关性（P〉0.05）。（3）ICP合并羊水污染组13例、无羊水污染组17例,两组脐血瘦素水平比较无明显差异（P〉0.05）。Apgar评分差异无显著性（P〉0.05）。结论ICP患者脐血瘦素水平增高是机体适应缺氧以满足胎儿宫内生长需求而发生的一种代偿性反应,对胎儿有促进作用,可能是胎儿安全的信号,一旦失代偿导致胎儿生长受限。

The Ieptin Ievel in umbilical vein blood of patients with intrahepatic cholestasis of pregnancy

Objective ： To investigate the leptin level in umbilical vein blood of patients with intrahepatic cholestasis of pregnancy （ICP）. Methods： 42 patients were selected in hospital at random of 30 patients with ICP and 12 normal pregnant women. Patients with ICP were divided into two groups according to different grading, different gestational age and whether or not meconium passage. radioimmunoassay was used to determine leptin. Statistical data were analyzed by SPSS16.0 . Results： （ 1 ） The leptin level in umbilical vein blood in the three groups , 15 in mild ICP group, 15 in severe ICP group and the normal group, showed no significant difference （ P 〉 0. 05）. There were positive correlations between cord serum leptin level and birth weight in normal group （ r = 0. 678, P = 0. 015 ）, but it had no means in ICP groups （ P 〉 0. 05 ）. （2） The leptin level in umbilical vein blood of 13 full - term patients with ICP were higher than that in 17 premature delivery group and the normal group （ P 〈0. 05）. The others showed no significant difference （ P 〉 0. 05）. Cord serum leptin level in ICP and in normal group had no correlation with gestational age （ P 〉 0. 05）. （3） There were 13 meconium passage in ICP , compaired with others, cord serum leptin levels in two group showed no significant difference （ P 〉 0. 05）. Apgar score were also no significant difference （ P 〉 0. 05）. Conclusion： The higher cord blood leptin level in patients with ICP improves the development of infant and adapts to hypoxia , once decompensated leads to fetal growth restriction.