妊娠期肝内胆汁淤积症不同胆汁酸值对围生结局的影响

Effect of different serum total bile acid in patients with intrahepatic cholestasis of pregnancy into perinatal-outcome

目的探讨妊娠期肝内胆汁淤积症(ICP)不同胆汁酸值对围生结局的影响。方法选择2002年2月—2004年12月ICP产妇117例作为研究对象。根据最佳临界值分为2组,分析不同胆汁酸值与围生结局的关系。结果预测发生不良围生结局的胆汁酸最佳临界值为34.90μmol/L。母血胆汁酸≥34.90μmol/L组剖宫产、羊水粪染、早产、新生儿窒息的发生率均比<34.90μmol/L组高,有显著性差异(P<0.05)。结论母血胆汁酸水平是预测ICP孕妇不良围生结局的一项重要指标,其预测不良围生结局的最佳临界值为34.90μmol/L,灵敏度为72.7%,特异度为81.0%。当血总胆汁酸水平≥34.90μmol/L时不良围生结局发生率明显增加。

Objective It is to investigate the effect of different serum total bile acid in patients with intrahepatic cholestasis of pregnancy （ICP） into the perinatal-outcome, Methods The 117 cases of ICP was analysed from Feb, 2002 to Dec, 2004. They were divided into two groups by the critical value of serum total bile acid and analyzed retrospectively the poor perinatal-outcome. Results The critical value of serum total bile acid to calculate poor perinatal-outcome was 34.90 μmol/L. Cesarean section, meconium stained amniotic fluid, premature delivery , neonatal asphyxia in group A（≥34.90μmol/L） were increased significandy compared with group B （ 〈 34.90μmol/L） （ P 〈 0.05）. Conclusion Maternal serum total bile acid is one of the important factors calculate the perinatal-outcome in patients with intrahepatic cholestasis of pregnancy and the critical value is 34.90μmol/L, with sensitivity 72.7 % and specificity 81.0 %. When maternal blood serum total bile acid levels exceed 34.90μmol/L, the risk rate of poor perinatal-outcome is increasing.