血清总胆汁酸测定诊断妊娠肝内胆汁淤积症的临床意义分析

目的：分析血清总胆汁酸（TBA）测定诊断妊娠肝内胆汁淤积症（ICP）的临床意义。方法选取本院收治的42例ICP孕妇作为观察组,另选择同期体检的40例健康孕妇为对照组,分别检测两组孕妇的血清TBA、ALT、AST、TBiL水平,并对比分析两组孕妇血清TBA、ALT、AST、TBiL指标水平和异常率及观察组孕妇不同孕周条件下血清TBA水平。结果观察组孕妇血清TBA、ALT、AST水平均高于对照组（P〈0.05）,且相较于ALT、AST,血清TBA对应的P值最小。观察组孕妇血清TBA、ALT、AST异常率均高于对照组（P〈0.05）,且相较于ALT、AST,血清TBA对应的P值最小。观察组孕妇血清TBA指标异常率高于ALT、AST异常率（P〈0.05）。随着妊娠肝内胆汁淤积症孕妇孕期的进展,血清TBA水平逐渐升高（P〈0.05）。结论相较于ALT、AST,血清TBA测定诊断ICP的灵敏性和特异性更好,可作为ICP患者常规检测项目之一。

Clinical significance analysis of serum total bile acid detection in the diagnosis of intrahepatic cholestasis of pregnancy

Objective To analyze the clinical significance of serum total bile acid（TBA）detection in the diagnosis of in-trahepatic cholestasis of pregnancy （ICP）. Methods 45 cases of pregnant women with ICP admitted and treated in our hospital were selected as observation group.40 healthy pregnant women receiving physical examination in the same pe-riod were selected as control group.Serum TBA,ALT,AST and TBiL levels was tested for pregnant women in two groups respectively.Serum TBA,ALT,AST and TBiL levels and abnormality rate between two groups was compared and anal-ysed respectively.Serum TBA level at different gestational weeks in the observation group was compared and analysed. Results TBA,ALT and AST levels in observation group was higher than that in control group respectively （P〈0.05）,with the lowest P value for serum TBA when compared with ALT and AST.Serum TBA,ALT and AST abnormality rate in ob-servation group was higher than that in control group respectively（P〈0.05）,with the lowest P value for serum TBA when compared with ALT and AST.TBA abnormality rate in observation group was higher than that ALT or AST abnormality rate respectively（P〈0.05）.Serum TBA level gradually increased with advance of gestation in pregnant women with intra-hepatic cholestasis of pregnancy（P〈0.05）. Conclusion Compared with ALT and AST,serum TBA detection demonstrates better sensitivity and specificity in the diagnosis of ICP,which can be used as a routine IPC detection item.