妊娠期肝内胆汁淤积症血清胆汁酸水平对孕妇及胎儿的影响

目的:探讨血清胆汁酸水平对妊娠期肝内胆汁淤积症(ICP)孕妇及胎儿的影响。方法:回顾性分析2007年6月~2010年6月在临安市中医院待产的64例ICP孕妇的病历资料,以血清胆汁酸水平(TBA)40μmol/L为界分为A组(>40μmol/L)和B组(<40μmol/L),比较两组孕妇的临床表现、黄疸程度、肝酶水平以及围生儿早产、胎儿窘迫、羊水粪染、新生儿窒息等方面的发生率。结果:①对孕妇的影响:A组孕妇皮肤瘙痒出现的时间更早,黄疸的程度更重,丙氨酸转氨酶、门冬氨酸转氨酶值的升高更明显。②对围生儿的影响:A组在早产、羊水粪染、胎儿窘迫、新生儿窒息等方面发生率比B组高,有明显统计学差异。结论:TBA是评估ICP孕妇及胎儿宫内情况及其预后的敏感指标,能可靠地反映其发生妊娠不良结局的可能性。

Effect of serum bile acid level on pregnant women with intrahepatic cholestasis of pregnancy and their fetuses

Objective:To explore the effect of serum bile acid level on pregnant women with intrahepatic cholestasis of pregnancy(ICP) and their fetuses.Methods:The medical records of 64 pregnant women with ICP waiting for birth in the hospital from June 2007 to June 2010 were analyzed retrospectively,then the pregnant women were divided into group A(>40 μmol/L) and group B(<40 μmol/L) according to serum bile acid level;the clinical manifestations,degrees of jaundice,liver enzymes levels and the incidences of premature delivery,fetal distress,meconium-stained amniotic fluid and neonatal asphyxia in the two groups were compared.Results:The effect on pregnant women: compared with group B,the onset time of cutaneous pruritus in group A was more earlier,the degree of jaundice was more severer,the values of alanine aminotransferase and aspartate aminotransferase increased more obviously.The effect on perinatal infants: the incidences of premature delivery,meconium-stained amniotic fluid,fetal distress and neonatal asphyxia in group A were significantly higher than those in group B.Conclusion:Serum bile acid is a sensitive index to assess the pregnant women with ICP,the intrauterine conditions of fetuses and the prognosis,which can reflect the possibility of adverse pregnancy outcomes.