妊娠肝内胆汁淤积症患者血清心肌酶检测及其临床价值

Clinical study of Lactate Dehydrogenase,Creatine Kinase and Gamma-glutamyltransferase in the Intrahepatic Cholestasis in Pregnancy

【目的】研究妊娠肝内胆汁淤积症(ICP)患者心肌酶水平及其临床价值。【方法】选取30例妊娠肝内胆汁淤积症患者及20例正常孕妇,比较血清中乳酸脱氢酶(LDH)、肌酸肌酶(CK)和γ谷氨酰转移酶(γ-GT)水平。【结果】ICP组总胆汁酸(TBA)、总胆红素(TB)、直接胆红素(DB),谷丙转氨酶,谷草转氨酶、乳酸脱氢酶和γ谷氨酰转移酶(-γGT)均高于正常对照组(P<0.05);ICP组间接胆红素(IB)和肌酸肌酶(CK)高于正常对照组,但差异无显著性(P>0.05)。在ICP组患者乳酸脱氢酶和γ-GT与TBA存在正相关(r=3.54,P<0.05),与TB、DBI、B、谷丙转氨酶及谷草转氨酶间不存在相关(P>0.05);CK与TB、DBI、B、胆汁酸、谷丙转氨酶及谷草转氨酶间不存在相关(P>0.05)。【结论】LDH和γ-GT增高可以提示诊断和预后,而CK没有诊断价值。

[Objective]To analyse the activity of LDH, CK and gamma-GT in blood serum of women with intrahepatic cholestasis in pregnancy （ICP）. [Methods]Women（ n = 30） with intrahepatic cholestasis （the study group） and 20 healthy women （the control group） entered the study. The serum levels of total bile acid （TBA）, total bilirubin, direct bilirubin, indirect bilirubin, dehydrogenase, creatine kinase and gamma-glutamyltransferase （γ-GT） were detected. [Results]The serum levels of total bilirubin bile acid, total bilirubin, direct bilirubin, dehydrogenase, and gamma-glutamyltransferase （γ-GT） in ICP were higher than those in control group（ P〈0.05）, but there was no significant difference of indirect bilirubin and creatine kinase between ICP and control group（ P〉0.05）. There were significant correlations among LDH, γ-GT and TBA in ICP. [Conclusion]An increase of LDH and γ-GT confirms the diagnosis and prognosis. CK does not present prognostic value.