妊娠期血清总胆汁酸的检测及临床意义

目的了解正常妊娠过程中血清总胆汁酸（TBA）含量变化及临床意义。方法采用日产Olympus Au-640自动生化分析仪检测215例正常孕妇不同妊娠阶段和136例末孕妇女血清总胆汁酸含量，并同时检测总胆红素（TBIL），直接胆红素（DBIL）、谷丙转氨酶（ALT）、谷草转氨酶（AST）。结果正常妊娠过程中，TBA、TBIL、DBIL、ALT、AST均有增高趋势，与未孕组比较，TBA在妊娠中期即开始显著升高（P〈0．05），妊娠晚期TBA增高更加显著（P〈0．01），而TBIL、DBIL、ALT、AST到妊娠晚期才显著升高（P〈0．01）。结论TBA含量在正常妊娠过程中有生理性改变（〈20umol／L），比TBIL、DBIL、ALT、AST改变早，其异常升高（〉40umol／L），对孕妇及胎儿危害较大，因此妊娠妇女应定期做TBA检测，有利于肝内胆汁淤积症（ICP）的早诊断、早治疗。

Detection and Clinical Significance of Level of Total Bile Acid in Serum of Women During Normal Pregnancy

Objective To investigate the alteration of total bile acid （TBA） in normal pregnant women and to explore its clinical significance. Methods The levels of serum TBA, total bilirubin （TBIL）, direct biiirubin （DBIL）, alanine aminotransferase （ALT）, and glutamic oxaloacetic transaminase （AST） of 215 normal pregnant women and 136 non - pregnant women were determined by Olympus Au- 640 whole autochemical analyzer. Results The TBA level of pregnant women in the Ⅱ and Ⅲ gestational periods was significantly increased as compared with that of the control group. The levels of TBIL, DBIL, ALT, and AST in the Ⅲ gestational period were significantly increased too （P〈 0.01 ）. Conclusion TBA level in normal pregnancy has the physiological change （〈 20 umol/L）, while compared with the levels of TBIL, DBIL, ALT, and AST, the changes occur earlier （ 〉 40 umol/L）. Abnormally increased TBA level is harmful to both mother and fetus, and therefore pregnant women should routinely detect TBA. It is a beneficial modality for the early diagnosis and treatment of intrahepatic cholestasis of pregnancy （ICP）.