摘要
目的探讨妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)对血液指标改变及围生结局的影响。方法方便选取2021年3月—2022年3月于福建省妇幼保健院分娩的128例ICP患者为研究对象,将10μmol/L<总胆汁酸(TBA)<40μmol/L的患者设为轻度ICP组(74例),TBA≥40μmol/L的患者设为重度ICP组(54例),另选取同时期在本院分娩的100名健康孕妇设为对照组,比较3组肝功能指标、凝血功能指标、血小板计数和围生结局。结果轻、重度ICP组的TBA、AST、ALT、TBIL、DBIL、FIB、D二聚体、FDP水平均高于对照组;重度ICP组TBA、AST、ALT、TBIL、DBIL、FIB、D二聚体、FDP水平均高于轻度ICP组,差异有统计学意义(P<0.05)。与对照组比较,轻、重度ICP组血小板计数均更低,差异有统计学意义(P<0.05);与轻度ICP组比较,重度ICP组血小板计数更低,差异有统计学意义(P<0.05)。对照组的围产结局较轻、重度ICP组均明显更优,差异有统计学意义(P<0.05);与轻度ICP组比较,重度ICP组早产、剖宫产、产后出血、羊水污染、低体重儿发生率均显著较高,差异有统计学意义(P<0.05)。结论ICP会影响肝功能指标、凝血功能指标、血小板异常及围生结局,尤其重度ICP患者的影响极大,需加强ICP患者孕期的诊断与监测,以改善围生结局。
Objective To investigate the influence of intrahepatic cholestasis of pregnancy(ICP)on blood index changes and perinatal outcomes.Methods 128 ICP patients who delivered at Fujian Maternal and Child Health Hospital from March 2021 to March 2022 were conveniently selected as the research subjects,Patients with μ mol/l<total bile acid(TBA)<40μmol/L were assigned to the mild ICP group(74 cases),Patients with TBA≥40μmol/L were assigned to the severe ICP group(54 cases),and 100 healthy pregnant women who delivered at our hospital during the same period were selected as the control group.Liver function indicators,coagulation function indicators,platelet count,and perinatal outcomes were compared among the three groups.Results The levels of TBA,AST,ALT,TBIL,DBIL,FIB,D-dimer,and FDP in the mild and severe ICP groups were higher than those in the control group,the levels of TBA,AST,ALT,TBIL,DBIL,FIB,D-dimer,and FDP in the severe ICP group were higher than those in the mild ICP group,and the difference was statistically significant(P<0.05).Compared with the control group,there was a statistically significant difference in platelet count between the mild and severe ICP groups(P<0.05);Compared with the mild ICP group,the severe ICP group had lower platelet counts,and the difference was statistically significant(P<0.05).The perinatal outcomes of the control group were significantly better than those of the mild and severe ICP groups,with a statistically significant difference(P<0.05).Compared with the mild ICP group,the incidence of premature birth,cesarean section,postpartum hemorrhage,amniotic fluid contamination,and low birth weight infants in the severe ICP group were significantly higher,and the difference was statistically significant(P<0.05).Conclusion ICP can affect liver function indicators,coagulation function indicators,platelet abnormalities and perinatal outcomes,especially in patients with severe ICP.It is necessary to strengthen the diagnosis and monitoring of ICP patients during pregnancy to improve perina
作者
唐海燕
吴志辉
徐榕莉
任坤海
TANG Haiyan;WU Zhihui;XU Rongli;REN Kunhai(Department of Laboratories,Fujian Maternal and Child Health Hospital,Fuzhou,Fujian Province,350005 China;Department of ObstetricsⅡ,Fujian Provincial Maternal and Child Health Hospital,Fuzhou,Fujian Province,350005 China)
出处
《中外医疗》
2023年第8期81-84,89,共5页
China & Foreign Medical Treatment
关键词
妊娠期肝内胆汁淤积症
肝功能指标
凝血功能指标
D二聚体
围产结局
Intrahepatic cholestasis of pregnancy
Liver function index
Coagulation function index
D-dimer
Perinatal outcome
