120例ICP患者血清中CG、TBA与TSH水平变化分析

目的探讨妊娠期肝内胆汁淤积症（ICP）患者血清中甘胆酸（CG）、总胆汁酸（TBA）与促甲状腺激素（TSH）水平的变化及其临床意义。方法选取妊娠期肝内胆汁淤积症（ICP）患者120例为实验组,对照组为94例正常妊娠者,分别测定其甘胆酸（CG）、总胆汁酸（TBA）与促甲状腺激素（TSH）水平并进行比较。结果与正常妊娠组相比,ICP患者血清中CG、TBA及TSH水平均显著升高,差异有统计学意义（P〈0.05～0.01）。结论监测ICP患者血清中CG、TBA及TSH水平的变化对判断病情,指导临床具有重要价值。     

总胆汁酸测定在妊娠期肝内胆汁淤积症中应用重要性的探讨

目的探讨总胆汁酸测定（TBA）在妊娠期肝内胆汁淤积症（ICP）中应用的重要性。方法对2400例妊娠晚期孕妇进行总胆汁酸、谷丙谷草转胺酶、碱性磷酸酶测定。结果（1）结合临床诊断ICP患者有245例。其中TBA值≥15μmol／L者为203例，TBA值≥30μmol／L者为42例。两者约占总数9．8％。（2）ICP组TBA测定值明显高于非ICP组P〈0．05。ICP组ALT、AST、ALP值与非ICP组相比，两者无显著意义。（3）将ICP组分为高低值组，高值组ALT、AST、ALP明显高于非ICP组P〈0．05。结论TBA水平是预测ICP孕妇其胎儿宫内情况及预后的一个重要指标。与其他生化指标ALT、AST、ALP相比特异性更高。当TBA值≥30μmol／L其围产儿发病率明显升高，预后较差。因此总胆汁酸测定在妊娠晚期孕妇中进行有着非常重要的临床意义。     

妊娠期妇女血清甘胆酸与血脂水平相关性研究

目的:探讨妊娠期妇女肝内胆汁淤积症(ICP)的发病率及甘胆酸(CG)与血脂、碱性磷酸酶(ALP)水平的相关性。方法:采用放射免疫分析检测甘胆酸,用酶法测定血脂,速率法测定ALP。结果:2040例妊娠期妇女中有18.5%CG值升高,其中有2.8%可确诊为ICP。ICP患者与正常妊娠组相比,TG、CHOL、LDL、ALP均明显升高,而HDL则略降低。结论:ICP为妊娠期常见并发症,应将CG作为常规产前检查项目。ICP患者结合分析其血脂、ALP水平,有助于病情判断。     

血清甘胆酸筛查妊娠期肝内胆汁淤积症的优势探讨

为探讨空腹血清甘胆酸(CG)检测对于筛查妊娠期胆汁淤积症(ICP)患者的优势,本文对400名正常孕妇和87例胆淤症妊娠患者的空腹血清CG、总胆汁酸(TBA)、总胆红素(TBIL)及丙氨酸氨基转移酶(ALT)检测结果进行回顾性分析.结果显示,ICP组血清CG值非常显著高于正常组(P＜0.001),其阳性率为100%,并早于TBA、TBIL和ALT,而后三者仅轻中度升高,阳性率分别为44.8%、11.5%和35.6%.因此,血清CG筛查为孕妇普查及时发现ICP的灵敏的经济的早期的血清学指标.     

肝炎相关性标志物检测在婴儿肝炎综合征的变化及临床意义

目的检测肝炎血清相关标志物水平，探讨该项指标在婴幼儿肝炎综合征中的变化及诊疗价值。方法临床确诊的婴儿肝炎综合征53例，采用全自动化学法分析技术，用杜邦全自动生化分析仪对53例肝炎综合征患儿及38例正常对照组婴幼儿进行血清TBA、ALP、ALT、AST、TBIL、DBIL肝功能指标测定。结果ALT、AST、ALP在该综合征时均值比正常上限升高约2—4倍；DBIL、TBIL升高3—6倍；而TBA则平均升高约8—10倍，患儿组血清TBA（80．84±48．06）μmol／L，异常率达94，3％，与正常对照组有显著性差异；TBA与垂清碱性磷酸酶（ALP）、直接胆红素（DBIL）检测水平有良好的相关性。结论TBA的灵敏度和特异性均优于常规指标，血清TBA测定在婴幼儿肝炎综合征的诊断、疗效观察及预后判断中均有重要临床意义，与ALP、DBIL联合检测，曼有利于婴儿肝炎综合征的诊疗。     

妊娠期肝内胆汁郁积症患者血清甘胆酸检测的临床价值

妊娠期肝内胆汁郁积症(ICP)是发生于妊娠中、晚期的疾病,该病对围产儿影响较大.为进一步探讨血清甘胆酸(CG)对ICP的临床诊断价值,用放射免疫法对孕妇、ICP患者检测了血清CG值,并与丙氨酸转氨酶(ALT)和碱性磷酸酶(ALP)进行了对比分析,结果是:ICP组CG值明显高于妊娠组,差异非常显著(P＜0.01),其阳性率为100%;ICP组ALT阳性率为80%,ALP阳性率为40%.因此,血清CG是目前诊断ICP最敏感的血清学指标.     

新疆不同民族孕妇血清CG水平的监测及其临床意义

探讨新疆不同民族孕妇血清甘胆酸 (CG)对妊娠期肝内胆汁郁积症 (ICP)的临床诊断价值。用放射免疫法检测正常少数民族及汉族孕妇和少数民族、汉族孕妇ICP患者血清CG及丙氨酸转氨酶 (ALT) ,并进行对比分析。结果显示 :正常妊娠中期少数民族、汉族孕妇CG含量无显著差异 (P >0 .0 5 ) ;正常妊娠晚期少数民族孕妇CG含量明显高于汉族孕妇 ,差异显著 (P <0 .0 5 ) ;不同民族ICP患者组CG含量和ALT水平均明显高于正常妊娠中、晚期组 ,有显著差异 (P <0 .0 1 ) ,少数民族ICP组CG含量和ALT水平均明显高于汉族ICP组 (P <0 .0 1 )。结论 :应将血清CG测定作为孕妇的常规检查 ,这对及时诊断和治疗ICP极为重要 ,同样要重视少数民族孕妇CG水平的监测 ,加强少数民族孕妇围产期的保健工作。     

妊娠期血清CG RIA的临床意义

应用放射免疫测定孕妇血清甘胆酸(CG)含量能够早期诊断妊娠期肝内胆汁淤积症(Intrahepic Cholestasis of Pregnancy,简称ICP)。最近,我们实验室应用放射免疫法测定了512例正常孕妇和24例ICP患者的血清CG含量,从而证明了CG测定对ICP有确切的诊断价值。 材料和方法 一,对象 (一)正常孕妇组;512例,年龄23～31岁(平均25.5岁),孕周20周～36周(从20周～27周末为中期妊娠组,28周～36周为晚期妊娠组),均来源于1996年到我院产科门诊作产前检查无异常者,肝功能正常。 (二)ICP组:24例,年龄25～32岁(平均27岁)孕周为30～38周。均系1996年在我院产科就诊发现有黄疸和/或皮肤瘙痒者,后经生化肝功能及CG测定确诊为ICP而住院者。 二、方法:孕妇早晨空腹抽取静脉血2ml,分离血清贮存于-20℃冰柜,集中后每周检测一次,血清     

3310例妊娠期血清甘胆酸水平回顾性分析

本文回顾分析3310例妊娠期血清甘胆酸(CG)水平,建立不同孕期CG参考范围,探讨CG增高结合临床及血清总胆汁酸(TBA)的测定结果进行分析、诊治,现报告如下。1 1对象和方法1.1对象均为2011.1～2012.1本院妇产科门诊和住院孕妇,既往无肝胆疾病史。对3310例孕妇进行血清CG测定,平均年龄(26.6±2.2)岁;对792例血清CG含量高于参考范围的孕妇进行血清TBA含量测定,平均年龄(27.5±3.1)岁。     

总胆汁酸水平与血压在妊娠期肝内胆汁淤积症妊娠结局中的交互作用

目的 探讨总胆汁酸（TBA）水平和血压对妊娠期肝内胆汁淤积症（ICP）妊娠结局的交互作用。方法 113例ICP孕妇作为研究对象,76例同期健康孕妇作为对照组,对比两组TBA和血压指标。再将患者分为不良妊娠结局组（n=42）和良好妊娠结局组（n=71）,分析ICP孕妇不良妊娠结局的危险因素,讨论TBA和血压对ICP患者妊娠结局的关联性,及其在ICP孕妇妊娠结局中的交互作用。结果 ICP组早产人数、SBP、DBP及TBA显著高于对照组（P<0.05）,分娩方式、孕期吸烟、孕产史、谷草转氨酶（AST）、谷丙转氨酶（ALT）、SBP、DBP、TBA及总胆红素（TBIL）水平显著影响ICP孕妇的妊娠结局（P<0.05）;TBA、SBP及DBP水平与ICP患者妊娠结局显著相关;TBA≥39.27μmol/L与高血压两因素共同存在时ICP患者不良妊娠结局发生风险更高。结论 TBA、SBP和DBP均为ICP患者不良妊娠结局的危险因素,随着TBA、SBP及DBP水平的升高,其关联效应值也相应增高,TBA和血压在ICP孕妇的妊娠结局中的存在交互作用。     

血清生物标志物水平在妊娠期肝内胆汁淤积症诊断中的临床意义

目的 探讨生物标志物水平在妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)诊断中的临床意义.方法 测定86例ICP产妇(轻度和重度各43例)和86位正常孕妇的血清总胆汁酸(total bile acid,TBA)、雌三醇(estriol,E3)、肿瘤坏死因子-d(tumor necrosis factor-α,TNF-α)、高敏C-反应蛋白(high sensitive C-reactive protein,hs-CRP)和降钙素原(procalcitonin,PCT)水平,并进行对比性分析和围生期结局比较.对血清TBA与E3、TNF-α、hs-CRP和PCT水平进行Pearson相关性分析.结果 86例ICP产妇的血清TBA、E3、TNF-α、hs-CRP和PCT水平较之86位正常孕妇明显增高(P均＜0.01),并随ICP产妇的严重程度而增高.血清TBA水平与E3、TNF-α、hs-CRP、PCT水平呈正相关(r分别为0.846、0.530、0.863和0.781,P均＜0.05).在围生期结局比较中,86例ICP产妇较之正常孕妇早产、羊水胎粪污染、新生儿窒息和胎儿窘迫的发生率明显增高(P＜0.01).结论 血清E3、TNF-α、hs-CRP、PCT与TBA水平呈正相关,并与妊娠期肝内胆汁淤积症严重程度及不良妊娠结局有关,上述血清学标志可作为疾病诊断、严重程度判断的重要指标,并提示上述指标可能参与ICP的发生和发展.     

赶黄草水提取物利胆退黄作用的研究

目的探讨赶黄草水提取物的利胆退黄作用。方法采用胆管引流法，观察赶黄草水提取物对正常大鼠胆汁分泌量的影响：采用胆管结扎致大鼠梗阻性黄疸模型和α-萘异硫氰酸酯（ANIT）致胆汁淤积模型，观察赶黄草水提取物对模型大鼠血清总胆红素（TBIL）含量、碱性磷酸酶（ALP）活性、γ-谷氨酰转移酶（GGT）活性、门冬氨酸转氨酶（AST）活性、丙氨酸转氨酶（ALT）活性的影响。结果赶黄草水提取物能增加正常大鼠胆汁的分泌量，但对血清TBIL含量无影响；对于胆管结扎所致梗阻性黄疸模型大鼠和ANIT所致的胆汁淤积模型大鼠．赶黄草水提取物能显著降低血清TBIL含量，抑制血清ALP、GGT、AST和ALT活性。结论赶黄草水提取物具有明显的利胆退黄作用。     

Liver and pregnancy

Transaminase level elevation during pregnancy should be viewed as abnormal and evaluated. A high index of suspicion for acute fatty liver of pregnancy should be maintained during the third trimester, since early delivery has radically transformed the maternal and fetal prognosis of this condition. Pruritus is the main symptom of intrahepatic cholestasis, which carries a risk for the fetus. Urinary tract infection can cause cholestasis or worsen intrahepatic cholestasis of pregnancy. In patients with preeclampsia, rapid delivery should be considered if there is evidence of HELLP syndrome. Patients with mild chronic viral hepatitis can usually carry a pregnancy to term without undue difficulty. Neonates born to HBsAg-positive mothers should receive HBV-Ig and vaccine at birth to prevent perinatal transmission of the HBV. In patients with chronic hepatitis C, serum transaminase levels often return to normal during pregnancy, although the virus remains detectable in the blood. Mother-to-infant transmission of the HCV is possible but fairly uncommon if the mother is HIV-negative.     

Some problems in the laboratory findings in multiple myeloma

The clinical usefulness of alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) levels in serum and pathogenetic mechanism of hypoalbuminemia and hypocholesterolemia in multiple myeloma (MM) were investigated. In cases of MM with a history of pathological fracture, the level of serum ALP was significantly higher than normal. Thus, elevated ALP in MM patients may be an indicator of the occurrence of a pathological fracture within the past 2 months. The levels of serum LDH in about 80% of the MM patients were within normal limits despite the presence of a malignant tumor. These patients showed a normal pattern of isoenzymes and more mature types according to the Greipp classification. In contrasts, the patients with elevated serum levels of LDH showed the tumor pattern of the isoenzymes and the plasmablastic type. The total cholesterol concentration was correlated with the total protein levels and the serum cholinesterase. These findings were the same as those in patients with nephrotic syndrome and polyclonal hypergammaglobulinemia without liver dysfunction. These results suggest that the decreased cholesterol in MM is due to a reduction in the synthesis of albumin in the liver.     

Vitamin E deficiency with normal serum vitamin E concentrations in children with chronic cholestasis

We studied serum vitamin E levels and the ratio of serum vitamin E to serum lipid levels in 11 children with chronic cholestasis complicated by vitamin E deficiency, as defined by characteristic neurologic signs or sural-nerve histopathology in addition to impaired intestinal absorption of vitamin E. Eight of the children had low levels of serum vitamin E, as well as low ratios of serum vitamin E to total lipids and to cholesterol. However, three patients had normal serum vitamin E levels but low ratios of serum vitamin E to total lipids (two of the three had normal ratios of vitamin E to cholesterol). In four patients who were not vitamin E-deficient, all three values were normal. We conclude that vitamin E deficiency may exist in a child with a normal serum vitamin E concentration and that the ratio of serum vitamin E to total serum lipids is the most reliable biochemical index of vitamin E status during chronic childhood cholestasis.