妊娠期肝内胆汁淤积症分度与孕妇基础状况相关性

目的：探讨孕妇妊娠期不同程度肝内胆汁淤积症（intrahepatic cholestasis of pregnancy,ICP）与其个体条件及预计产后情况的关系。方法：按体征及血液学检测结果将328例ICP孕妇分为轻度及重度2组,并选取150名正常孕妇作为对照组。分别检测3组的甘胆酸（CG）、血清总胆红素（TBIL）、直接胆红素（DBIL）、丙氨酸转移酶（ALT）及天冬氨酸转移酶（AST）,并对结果进行分析,详细比较3组孕妇的个体基本条件及妊娠预后,探讨其与ICP分度的关系。结果：3组孕妇间CG值差异均存在统计学意义（P均〈0.001）;肝功能指标TBIL、DBIL、ALT及AST在轻度ICP孕妇组与正常孕妇组间差异无统计学意义,但重度组与轻度组间差异有统计学意义（P〈0.001）,且随孕妇年龄增长,ICP病情存在加重趋势。从孕、产妇结局与ICP的相关性研究可知,正常对照组孕妇的剖宫产率为21.33%,而轻度ICP组和重度ICP组剖宫产率分别达45.83%和93.75%;对照组孕妇仅有6.67%羊水粪染,而轻度ICP组和重度ICP组孕妇羊水粪染率分别为11.11%和38.39%。结论：孕妇血清CG、TBIL、DBIL、ALT及AST测定值与其ICP病情轻、重密切相关,轻度和重度ICP孕妇在妊娠结局的诸多方面与正常对照组的差异都有统计学意义。

The relationship between intrahepatic cholestasis severity and fundamental condition in pregnant women

Objective To investigate the relationship between intrahepatic cholestasis IC severity and fundamental condition in pregnant women. Methods Three hundred and twenty-eight pregnant women with IC were divided into mild IC and severe IC groups based on symptom-sign and results of laboratory tests and 150 normal pregnant women serve as normal control group. CG （Cholyglycine）,TBIL,DBIL,ALT and AST were determined and the results of these tests in association with the fundamental condition of patient and prognosis were analyzed. Results CG differed significantly among the 3 groups （severe IC group, mild IC group, and normal control group） （P〈0.001）. No significant difference in TBIL, DBIL, ALT and AST was found between mild IC group and normal control group, but there was significant difference between mild IC group and severe IC group （P〈0.001）. ICP had a trend of being more severe with the aging of pregnant women. The cesarean-section delivery rates of normal control group, mild IC group and severe IC group were 21.33%, 45.83% and 93.75%, respectively. Amniotic fluid contamination rates in these there groups three 6.67%, 11.11% and 38.39%, respectively. Conclusions The values of CG, TBIL, DBIL, ALT and AST had close correlation with the severity of IC. The course and outcome of pregnancy differes significantly between the IC groups and normal control group.