妊娠期肝内胆汁淤积症相关指标的临床意义

目的探讨生化指标与妊娠期肝内胆汁淤积症(ICP)的相关性及临床意义。方法筛选678例正常妊娠者及102例妊娠期ICP患者,分别测定血清总胆汁酸(TBA)、总胆红素(TB)、直接胆红素(DB)、甘胆酸(CG)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、γ-谷氨酰转移酶(GGT)和乳酸脱氢酶(LDH)。将正常妊娠者与妊娠期ICP患者的静脉血、脐血及羊水分别进行比较。结果 ICP组静脉血TBA、TB、DB、CG、ALT、AST、ALP、GGT、LDH与正常妊娠者静脉血比较差异有统计学意义(P<0.05),ICP组脐血TBA、TB、DB、CG、ALT、AST、ALP、LDH与正常妊娠者静脉血比较差异有统计学意义(P<0.05),ICP组羊水TBA、TB、CG、ALT、ALP、GGT、LDH与正常妊娠者静脉血比较差异也有统计学意义(P<0.05)。结论 CG、TBA、AST、ALT、ALP可作为ICP诊断可靠而实用的指标,可帮助终止妊娠时机的选择。

The role of the indicators and clinical significance in intrahepaticcholestasis of pregnancy

Objective To investigate the relativity and significance between biochemical index and intrahepatic cholestasis of pregnancy（ICP）. Methods 678 normal pregnancy women and 102 intrhepatic cholestasis of pregnancy women were elected, lndexs including TBA, TB, DB, CG, ALT, AST, ALP, GGT, and LDH were detected. And the index in the normal pregnancy and abnormal pregnancy in the blood, ord blood and amniotic fluid were compared. Results There was significant difference in TBA, TB, DB, CG, ALT, AST, ALP, GGT, LDH between the ICP group with the normal control group（P〈0.05） in the blood. There was significant difference in TBA, TB, DB, CG, ALT, AST,ALP,and LDH between the ICP group in cord blood with the normal control group（P〈0.05） in the blood. There was significant difference in TBA, TB,CG, ALT, ALP, GGT, LDH between the ICP group in amniotic fluid with the normal control group（P〈0.05） in the blood. Conclusion CG,TBA, AST, ALT,and ALP should be examined as the reliable and applied index for the diagnosis of ICP.