摘要
目的比较不同孕周起病的妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)患者的血清生化指标差异和围产儿结局,为早发型ICP的诊断提供临床依据。方法对成都市妇女儿童中心医院2014年12月至2017年5月收治的304例ICP患者进行回顾性研究,将所有患者按起病孕周分为3组,孕周<28周为A组(59例),28～31周为B组(72例),≥32周为C组(173例)。比较3组患者血清总胆汁酸(total bile acid,TBA)、丙氨酸转氨酶(alanine aminotransferase,ALT)、天冬氨酸转氨酶(aspartate aminotransferase,AST)、总胆红素(total bilirubin,TBIL)及早产率、剖宫产率、羊水粪染发生率、新生儿出生体重、新生儿窒息发生率的差异。结果 A组患者血清TBA水平、早产率、剖宫产率、羊水粪染发生率高于B、C组,差异有统计学意义(P <0. 05),B、C两组比较差异无统计学意义(P>0. 05);新生儿出生体重C组高于A、B组(P <0. 05),A、B组比较差异无统计学意义(P> 0. 05); 3组患者ALT、AST、TBIL水平比较差异无统计学意义(P> 0. 05)。结论妊娠28周前后起病的ICP患者血清生化指标和围产儿结局存在明显差异,而32周前后起病的患者差异不明显,可将早发型ICP的诊断界定为28周。
Objective To compare the serum biochemical indicators and perinatal outcome of intrahepatic cholestasis of pregnancy( ICP) with different onset time,and provide diagnostic basis for early-onset ICP. Methods A total of 304 ICP cases were collected in the Chengdu Women's and Children's Central Hospital from December 2014 to March 2017. Patients were divided into three groups by onset of gestational weeks,group A( onset time < 28 gestational weeks),group B( onset time 28 ~ 31 gestational weeks),and group C( onset time ≥ 32 gestational weeks). The total bile acid( TBA),alanine aminotran sferase( ALT),aspartate aminotransferase( AST),total bilirubin( TBIL),premature delivery rate,cesarean section rate,amniotic fluid stool infection rate,birth weight of newborn,incidence of neonatal asphyxia were compared between the three groups. Results The serum TBA level,premature birth rate,cesarean section rate and amniotic fluid stool infection rate in group A were higher than those in group B and C,the difference was statistically significant( P < 0. 05). There was no significant difference between groups B and C( P > 0. 05). The birth weight of newborns was higher in group C than in group A and B( P < 0. 05). There was no significant difference between groups A and B( P > 0. 05). There was no significant difference in the levels of ALT,AST,and TBIL between the 3 groups( P > 0. 05).Conclusion The serum biochemical indexes and perinatal outcomes of ICP patients before and after 28 weeks were significantly different,but there was no obvious difference before and after 32 weeks. Early diagnosis of ICP can be defined as 28 weeks.
作者
潘玥
李娥琼
PAN Yue;LIE -qiong(Department of Obstetrics,Chengdu Women's and Children's Central Hospital,Chengdu Sichuan 610000,P.R.China)
出处
《中国计划生育和妇产科》
2019年第1期53-55,62,共4页
Chinese Journal of Family Planning & Gynecotokology
关键词
妊娠期肝内胆汁淤积症
早发型
生化指标
围产儿结局
intrahepatic cholestasis of pregnancy
early -onset
biochemical indicator
perinatal outcome
