妊娠期肝内胆汁淤积症血清胆汁酸检测的临床意义

目的　探讨妊娠期肝内胆汁淤积症血清胆汁酸浓度与临床表现及预后的关系。方法　按血清胆汁酸测值分A,B,C三组 (A组 10 4~20μmol/L, 33例;B组 21~40μmol/L, 45例,C组 >40μmol/L, 17例 ),分析胆汁酸与皮肤瘙痒、黄疸、肝功及预后的关系。结果　胆汁酸越高,病情越重、肝功异常越明显,发生黄疸越多,瘙痒出现时间越早,早产、难产和胎儿宫内窘迫发病率越高。结论　测定胆汁酸对妊娠期肝内胆汁淤积症的诊断、病情判断、预后分析有重要意义。

Clinical Significance of Serum Bile Acid Detection in Intrahepatic Cholestasis during Pregnancy

Objective To explore the serum bile acid concentration in intrahepatic cholestasis during pregnancy and its relationship with clinical manifestation and prognosis. Methods All the patients were divided into three groups on the basis of serum bile acid concentration, i.e. group A (10.4~20.0 μmol/L, 33 patients), group B (21.0-40.0 μmol/L, 45 patients) and group C (>40.0 μmol/L, 17 patients). The relationship between serum bile acid concentration and some clinical manifestation or prognosis was analyzed. Results The clinical manifestation such as jaundice and abnormal liver function became much more common with the increase of serum bile acid concentration. The higher the concentration was, the earlier the itch occurred. Also, the rates of premature delivery, dystocia and fetal distress were related with its concentration.Conclusion It is significant to the diagnosis, evaluation and prognosis to measure the serum bile acid concentration in the pregnant women with intrahepatic cholestasis.