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目的:探讨孕妇妊娠期不同程度肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)与其个体条件及预计产后情况的关系。方法:按体征及血液学检测结果将328例ICP孕妇分为轻度及重度2组,并选取150名正常孕妇作为对照组。分别检测3组的甘胆酸(CG)、血清总胆红素(TBIL)、直接胆红素(DBIL)、丙氨酸转移酶(ALT)及天冬氨酸转移酶(AST),并对结果进行分析,详细比较3组孕妇的个体基本条件及妊娠预后,探讨其与ICP分度的关系。结果:3组孕妇间CG值差异均存在统计学意义(P均<0.001);肝功能指标TBIL、DBIL、ALT及AST在轻度ICP孕妇组与正常孕妇组间差异无统计学意义,但重度组与轻度组间差异有统计学意义(P<0.001),且随孕妇年龄增长,ICP病情存在加重趋势。从孕、产妇结局与ICP的相关性研究可知,正常对照组孕妇的剖宫产率为21.33%,而轻度ICP组和重度ICP组剖宫产率分别达45.83%和93.75%;对照组孕妇仅有6.67%羊水粪染,而轻度ICP组和重度ICP组孕妇羊水粪染率分别为11.11%和38.39%。结论:孕妇血清CG、TBIL、DBIL、ALT及AST测定值与其ICP病情轻、重密切相关,轻度和重度ICP孕妇在妊娠结局的诸多方面与正常对照组的差异都有统计学意义。
Objective: To investigate the relationship between intrahepatic cholestasis of pregnancy (ICP) in pregnant women and their individual conditions and postpartum conditions. Methods: According to the signs and hematological test results, 328 pregnant women were divided into mild and severe ICP group and 150 normal pregnant women as the control group. Three groups of CG, TBIL, DBIL, ALT and AST were detected, The results were analyzed in detail to compare the basic conditions of pregnant women in each group and the prognosis of pregnancy, and to explore its relationship with ICP classification. Results: There were significant differences in CG values between the three groups of pregnant women (all P <0.001). There were no significant differences in the liver function indexes TBIL, DBIL, ALT and AST among mild ICP pregnant women and normal pregnant women, The difference between the two groups was statistically significant (P <0.001), and as the age of pregnant women increased, the incidence of ICP tended to increase. According to the correlation between pregnancy and maternal outcome and ICP, the cesarean section rate of pregnant women in normal control group was 21.33%, while that in mild ICP group and severe ICP group was 45.83% and 93.75% respectively. The pregnant women in control group Only 6.67% of amniotic fluid meconium stained, while mild ICP group and severe ICP group pregnant women meconium-stained rates were 11.11% and 38.39%. Conclusion: The serum levels of CG, TBIL, DBIL, ALT and AST in pregnant women are closely related to the mild and severe ICP. The difference between pregnant women with mild and severe ICP and normal pregnant women is statistically significant.