摘要
目的探讨妊娠肝内胆汁淤积症（ICP）的发病规律和诊断。方法对我院近十年收治的1241例ICP患者病例资料进行回顾性分析。结果ICP占同期产科住院孕妇总数的5．2%,冬季发病多于其它季节;ICP多胎妊娠3．5%;ICP复发率30．2%。ICP平均发病孕周32．6周,88．5%发生于孕晚期;均有以皮肤瘙痒为主的症状,96．8%以皮肤瘙痒为首发症状,尚有以血清氨基转移酶（ALT和AST）升高（28例,2．3%）、黄疸症状（8例）、腹泻（3例）、尿黄（2例）、肝区疼痛（1例）为首发表现者。均有血清氨基转移酶水平升高,约60%分布于50～200 U/L;33．4%血清总胆红素升高,约85%分布于30-90μmol/L,不超过170μmol/L;仅82．4%总胆酸高于正常水平。结论皮肤瘙痒症状、以及以血清氨基转移酶和胆汁酸水平升高是诊断ICP的两个基本条件;同时留意ICP早期的不典型表现,以便及时发现ICP。
Objective To study the clinical features and diagnosis of intrahepatic cholestasis of pregnancy （ICP）. Methods During the last 10 years 1241 cases of ICP stayed in our hospital. Their clinical data were retrospectively reviewed. Results 5.2% of all the maternity patients had ICP. It occurred more in winter and 3.5% of ICP occurred in multiple pregnancies. The recurrence rate of ICP was 30.2%. On the average, it occurred at gestational week 32.6. Skin pruritus was the characteristic manifestation and the presenting symptom in 1201 patients （96.8%）. The other presenting features included elevated serum ALT and AST （2.3%）, jaundice （8 patients）, diarrhea （3 patients）, deep yellow urine （2 patients） and fight upper abdominal pain （1 patient）. The serum transaminases levels were elevated, of which 60% were between 50-200 IU/L. Serum total bile acid （TBA） levels were elevated in 82.4% of the patients and bilirubin levels in 33.4%. The elevated bilirubin levels were 30 to 90 μmol/L in 85% of those patients with this condition, and it was never higher than 170 μmol/L. Conclusion The basic diagnostic points of ICP are pruritus and abnormal liver function characterized by increased transaminases and TBA. Therefore paying attention to typical pruritus and other atypical features such as elevated serum transaminases, jaundice, diarrhea, deep yellow urine and fight upper abdominal pain during antenatal care is important for an early diagnosis of ICP.
出处
《中华肝脏病杂志》
CAS
CSCD
北大核心
2007年第4期291-293,共3页
Chinese Journal of Hepatology
关键词
胆汁淤积
肝内
诊断
妊娠并发症
Cholestasis, intrahepatic
Diagnosis
Pregnancy complications
