摘要
目的:探究妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)总胆汁酸(total bile acid,TBA)水平及终止妊娠的不同时间对围产儿结局产生的影响。方法:选取本院2017年1月-2018年6月住院分娩的妊娠期肝内胆汁淤积症孕妇60例作为研究对象,根据其体内总胆汁酸水平进行分组,将总胆汁酸水平<40 mol/L的30例作为低水平组(A组),包括终止妊娠孕周<36周的10例为AC组和≥36周的20例为AD组;将总胆汁酸水平≥40 mol/L的30例作为高水平组(B组),包括终止妊娠孕周<36周的9例为BC组和≥36周的21例为BD组。分析比较孕妇不同总胆汁酸水平与不同终止妊娠时间对围产儿不良结局的影响,以及A、B组间的肝功能指标水平。结果:B组的总胆红素(TBIL)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、血清TBA指标水平均明显高于A组,差异均有统计学意义(P<0.05)。AC组围产儿各项不良结局发生率均明显高于AD组,BC组均明显高于BD组,差异均有统计学意义(P<0.05)。结论:当孕妇总胆汁酸水平<40 mol/L且孕周≥36周时,终止孕妇妊娠有利于降低围产儿不良结局的发生率;当孕妇总胆汁酸水平>40 mol/L且孕周<36周时,终止产妇妊娠可以降低围产儿发生不良结局的发生率,控制总胆汁酸水平相关指标的平衡,采取积极治疗的方式可治疗妊娠期肝内胆汁淤积症孕妇。
Objective:To explore the effect of total bile acid(TBA)level and different termination time of pregnancy in intrahepatic cholestasis of pregnancy(ICP)and its influence on perinatal outcome.Method:A total of 60 pregnant women with intrahepatic cholestasis of pregnancy who were hospitalized and delivered in our hospital from January 2017 to June 2018 were selected as the study objects.According to their total bile acid levels,30 cases pregnant women with total bile acid levels<40 mol/L were divided into low level group(group A),including 10 cases pregnant women with termination of gestational weeks<36 weeks as AC group and 20 cases pregnant women with termination of gestational weeks≥36 weeks as AD group;30 cases pregnant women with total bile acid levels≥40 mol/L were divided into high level group(group B),including 9 cases pregnant women with termination of gestational weeks<36 weeks as BC group and 21 cases pregnant women with termination of gestational weeks≥36 weeks as BD group.The influence of different levels of total bile acid and different termination time of pregnancy on perinatal adverse outcomes,as well as the level of liver function indicators between A and B groups were analyzed and compared.Result:The levels of total bilirubin(TBIL),aspartate aminotransferase(AST),alanine aminotransferase(ALT)and serum TBA in group B were significantly higher than those in group A,the differences were statistically significant(P<0.05).The incidence of perinatal adverse outcomes in AC group were significantly higher than those in AD group,BC group were significantly higher than those in BD group,the differences were statistically significant(P<0.05).Conclusion:When the total bile acid level of pregnant women is less than 40 mol/L and gestational weeks are more than 36 weeks,termination of pregnancy is beneficial to reduce the incidence of perinatal adverse outcomes.When the total bile acid level of pregnant women is more than 40 mol/L and gestational weeks are less than 36 weeks,termination of pregnancy can redu
作者
江金娜
JIANG Jinna(Nanchang New District People’s Hospital,Nanchang 330100,China)
出处
《中国医学创新》
CAS
2019年第1期124-127,共4页
Medical Innovation of China
基金
江西省卫生计生委科技计划项目(20171264)
关键词
妊娠期肝内胆汁淤积症
总胆汁酸水平
终止妊娠时间
围产儿结局
Intrahepatic cholestasis of pregnancy
Total bile acid level
Termination of pregnancy
Perinatal outcome
