妊娠期肝内胆汁淤积症围生儿血气分析值与胎盘结构变化的相关性研究

Relationship between the change of placenta and umbilical cord arterial blood gas analysis of fetuses in intrahepatic cholestasis of pregnancy

目的探讨妊娠期肝内胆汁淤积症(Intrahepatic Cholestasis of Pregnancy,ICP)围生儿出生即刻脐动脉血血气分析值和胎盘绒毛间隙及合体结节面积的变化及其相关性。方法选择ICP晚期妊娠60例,正常晚期妊娠25例,测定围生儿出生即刻脐动脉血血气分析值(PH值、血氧分压PO2及二氧化碳分压PCO2),运用体视学方法测量胎盘绒毛间隙及合体结节的面密度;分析血气分析值与胎盘结构之间的相关性。结果ICP患者胎盘绒毛间隙面密度减小,合体结节面密度增大,围生儿出生即刻脐动脉血pH值、PO2均显著降低,PCO2升高。胎儿脐动脉血pH值、PO2与胎盘绒毛间隙面密度呈正相关,与合体结节面密度呈负相关;PCO2值与绒毛间隙面密度呈负相关,而与合体结节面密度呈正相关。结论ICP患者胎盘血液灌流量减少,绒毛有效交换面积减小,易出现胎儿宫内缺氧。

Objective To investigate the correlation between the placenta intervillous space area density and the indexes of umbilical cord arterial blood in Intrahepatic Cholestasis of Pregnancy （ICP）. Methods 60 late pregnant women of ICP and 25 normal late pregnant women were investigated, pH, PO2 , PCO2 of umbilical cord arterial blood gas analysis of fetuses were observed, the placenta intervillous space area density were measured by stereological method. Results In ICP, the placenta interviUous space area density was decreased, pH and PO2 of umbilical cord arterial blood were decrease and PCO2 was increase evidently. It was found that there was a positive correlation between pH, PO2 and the placenta interviUous space area density, and a negative correlation between PCO2 and the placenta intervillous space area density. Conclusion In ICP, the blood exchange area between the matrix and the fetus is decreased. The effective＇intervillous exchange acreage is decreased. So it＇ s easier for ICP fetuses to have distress because of the short of blood and oxygen.