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目的:探讨血清胆汁酸水平对妊娠期肝内胆汁淤积症(ICP)孕妇及胎儿的影响。方法:回顾性分析2007年6月~2010年6月在临安市中医院待产的64例ICP孕妇的病历资料,以血清胆汁酸水平(TBA)40μmol/L为界分为A组(>40μmol/L)和B组(<40μmol/L),比较两组孕妇的临床表现、黄疸程度、肝酶水平以及围生儿早产、胎儿窘迫、羊水粪染、新生儿窒息等方面的发生率。结果:①对孕妇的影响:A组孕妇皮肤瘙痒出现的时间更早,黄疸的程度更重,丙氨酸转氨酶、门冬氨酸转氨酶值的升高更明显。②对围生儿的影响:A组在早产、羊水粪染、胎儿窘迫、新生儿窒息等方面发生率比B组高,有明显统计学差异。结论:TBA是评估ICP孕妇及胎儿宫内情况及其预后的敏感指标,能可靠地反映其发生妊娠不良结局的可能性。
Objective: To investigate the effect of serum bile acid level on pregnant women and fetus during intrahepatic cholestasis of pregnancy (ICP). Methods: The clinical data of 64 pregnant women with ICP who were hospitalized in Lin’an Hospital of Traditional Chinese Medicine from June 2007 to June 2010 were retrospectively analyzed. The serum bile acid levels (TBA) of 40μmol / The clinical manifestations, the degree of jaundice, the level of liver enzymes and the incidence of perinatal preterm birth, fetal distress, meconium-stained amniotic fluid and neonatal asphyxia were compared between the two groups. Results: ①The effect on pregnant women: The pruritus of pregnant women in group A appeared earlier and the severity of jaundice was heavier. The increase of alanine aminotransferase and aspartate aminotransferase was more obvious. ② on the impact of perinatal children: A group of preterm birth, meconium-stained amniotic fluid, fetal distress, neonatal asphyxia and other aspects of the incidence was higher than the B group, there was a statistically significant difference. Conclusion: TBA is a sensitive index to evaluate intrauterine conditions and prognosis in ICP pregnant women and fetuses, which can reliably reflect the possibility of adverse outcomes in pregnancy.