妊娠期肝内胆汁淤积症159例的围产结局分析

目的探讨妊娠期肝内胆汁淤积症(ICP)患者的围产结局。方法选择159例ICP孕妇,根据实验室检查结果将其分为轻型50例,重型109例,比较不同实验室指标分组及不同分型ICP的围产结局。结果甘胆酸(CG)≥64.43 pmol/L组患者较CG<64.43 pmol/L在早产、胎儿宫内窘迫、新生儿窒息的发生率中显著增加(P均<0.05)。丙氨酸氨基转移酶(ALT)或天冬氨酸氨基转移酶(AST)≥250 U/L组与ALT<250 U/L且AST<250 U/L组比较及总胆汁酸(TBA)≥40μmol/L组与TBA<40μmol/L组比较,前者在早产、胎儿宫内窘迫、新生儿窒息的发生率均显著高于后者(P均<0.05)。轻、重型ICP不良围产结局比较后发现重型ICP患者早产、胎儿宫内窘迫、新生儿窒息发生率显著高于轻型ICP患者(P均<0.05)。结论应根据ICP分型及时对症处理治疗,从而有助于改善围产儿预后。

Perinatal outcomes analysis of 159 cases of intrahepatic cholestasis

Objective To investigate the perinatal outcomes in patients with intrahepatic cholestasis of pregnancy （ICP）. Methods One hundred fifty - nine cases of ICP pregnant women were collected in our hospital. According to the laboratory test results, they were divided into 50 cases of mild type and 109 cases of severe type. Perinatal outcomes were compared in different types of ICP and different laboratory parameters. Results Preterm birth, fetal distress and neonatal asphyxia were significantly increased in cholyglycine （CG） 964.43 pmol/L patients than CG 〈 64.43 pmol/L （ P 〈 0.05 ）. Comparison of alanine aminotransferase （ALT） or aspartate aminotransferase （AST） t〉 250 U/L group and ALT 〈250 U/L and AST 〈250 U/L group, total bile acid （TBA） ≥ 40 μmol/L group and TBA 〈40 μmol/L group found that preterm birth, fetal distress, neonatal asphyxia rate in the former were significantly higher than the latter （ P 〈 0.05 ）. Comparison of adverse perinatal outcomes between mild and severe ICP showed that incidence of pretenn birth, fetal distress and neonatal asphyxia was significantly higher in patients with severe ICP than patients with mild ICP （ P 〉 0.05 ）. Conclusion Different treatment options should be selected according to ICP type to improve perinatal outcomes.