甘胆酸对妊娠期肝内胆汁淤积症的诊断价值

THE DIAGNOSTIC VALUE OF GLYCOCHOLIC ACID FOR INTRAHEPATIC CHOLESTASIS IN PREGNANCY

应用甘胆酸放射免疫分析法（ＣＧＲＩＡ）检测孕妇血清ＣＧ的含量，正常孕妇（对照组）３２孕周后随妊娠月份增加血清ＣＧ含量略有上升，孕３１周前以血清ＣＧ含量＜７．０μｍｏｌ／ｌ为对照，３２孕周后以血清ＣＧ含量＜９．４μｍｏｌ／ｌ为对照。妊娠期肝内胆汁淤积（ＩＣＰ）患者血清ＣＧ值１００％增高，约５０％患者血清ＣＧ值升高先于瘙痒症状出现及谷丙转氨酶（ＡＬＴ）的升高。早在孕２０周即出现血清ＣＧ含量增高，因此测定ＣＧ含量是早期诊断ＩＣＰ患者最灵敏的方法。ＩＣＰ患者血清ＣＧ含量愈高，胎儿窘迫率也愈高，动态观察ＩＣＰ患者血清ＣＧ含量是监测胎儿预后的一项可靠指标。

The content of glycocholic acid(CG)in pregnant women's sera is detected with CG radioim munoassay(RIA).The content of CG in sera of normal pregnant women after 32 weeks is ascended slightly with the increasing of pregnant month. It is less than 7.0 μmol/l before 31 weeks in pregnancy and less than 9. 4 μmol/l after 32 weeks. The serum CG content of patients with intrahepatic cholestasis in pregnancy(ICP)is increased by 100%. The CG value of about half patients appears ear lier than pruritus and ALT rise, the earliest CG increasing appears in the 20th pregnant week.It is the most sensitive method for ICP early diagnosis.136 cases of ICP patients are observed and the results show that the higher the CG content,the higher the rate of intrauterine fetal anoxia;therefore, the dy namic observation of CG content in ICP patients is a dependable objective for surveillance of fetal prog nosis.