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目的探讨生化指标检测对妊娠期肝内胆汁淤积症(ICP)患者的临床诊断意义。方法选择55例妊娠期ICP患者作为ICP组和50例健康妊娠产妇作为对照组,对她们进行丙氨酸氨基转移酶、血清总胆汁酸、胆固醇等17项生化指标的测定。结果 ICP组与健康对照组相比TBA、ALT、AST水平明显升高,AST/ALT比值明显低于健康对照组,P<0.01。当以TBA>20μmol/L、ALT>55U/L、AST>55U/L、AST/ALT<1为阳性标准时,TBA、ALT、AST、AST/ALT对ICP诊断的敏感性分别为87.5%、85.1%、82.7%和86.3%,特异性分别为91.2%、88.6%、78.7%和76.1%,准确性分别为90.1%、85.2%、79.5%和86.2%。结论 CG、TBA、ALT、AST以及AST/ALT比值检测,可作为ICP的临床诊断依据,TC、TG检查可以作为对ICP诊断的辅助检查手段。
Objective To investigate the clinical significance of biochemical detection in patients with intrahepatic cholestasis of pregnancy (ICP). Methods 55 pregnant women with ICP were selected as the ICP group and 50 healthy pregnant women as the control group, and 17 biochemical indexes such as alanine aminotransferase, serum total bile acid and cholesterol were measured. Results The levels of TBA, ALT and AST in ICP group were significantly higher than those in healthy control group, and the ratio of AST / ALT was significantly lower than that in healthy control group (P <0.01). The sensitivity of TBA, ALT, AST and AST / ALT to the diagnosis of ICP were 87.5% and 85.1 respectively when the TBA> 20μmol / L, ALT> 55U / L, AST> 55U / L and AST / ALT <1 were positive %, 82.7% and 86.3% with specificity of 91.2%, 88.6%, 78.7% and 76.1%, respectively. The accuracy was 90.1%, 85.2%, 79.5% and 86.2% respectively. Conclusions The detection of CG, TBA, ALT, AST and AST / ALT ratio can be used as the basis for clinical diagnosis of ICP. TC and TG tests can be used as auxiliary examination methods for ICP diagnosis.