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目的研究脂代谢与肝功能对妊娠期肝内胆汁淤积症(ICP)患者的临床意义。方法选取827例ICP患者为观察组、935例正常妊娠妇女为对照组,观察组分脂代谢正常(A组)与脂代谢异常(B组);采用全自动生化分析仪检测总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(Apo A1)、载脂蛋白B(Apo B)、白蛋白(ALB)、总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆汁酸(TBA)等临床指标;计算动脉硬化指数(AI)。结果与对照组比较,观察组TC、TG、LDL-C、Apo B、AI水平上升,HDL-C、HDL-C/LDL-C、HDL-C/TC、Apo A1、Apo A1/Apo B水平下降;观察组中B组患者TBIL、DBIL、IBIL、ALT、AST、TBA水平均高于A组,ALB水平低于A组,其发生胎儿心率异常、羊水污染、早产与新生儿并发症的发生率上升水平,差异均具有统计学意义(P<0.05)。结论 ICP患者治疗时要关注其脂代谢与肝功能变化,及时采取干预措施。
Objective To study the clinical significance of lipid metabolism and liver function in patients with intrahepatic cholestasis of pregnancy (ICP). Methods A total of 827 patients with ICP were selected as observation group and 935 normal pregnant women as control group. Lipid metabolism was normal (group A) and lipid metabolism (group B). Total cholesterol (TC) TG, HDL-C, LDL-C, Apo A1, Apo B, albumin (ALB), total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bile acid (TBA) ; Calculate the arteriosclerosis index (AI). Results Compared with the control group, the levels of TC, TG, LDL-C, Apo B, AI, HDL-C, HDL-C / LDL-C, HDL-C / TC, Apo A1, Apo A1 / Apo B The level of TBIL, DBIL, IBIL, ALT, AST and TBA in group B were higher than that in group A, and the level of ALB in group B was lower than that in group A. The occurrence of fetal heart rate abnormalities, amniotic fluid contamination, premature birth and neonatal complications occurred in group B Rate of increase, the differences were statistically significant (P <0.05). Conclusion ICP patients should pay attention to their lipid metabolism and liver function changes, and timely interventions.