高效液相色谱串联质谱法对妊娠期肝内胆汁淤积症孕妇血清石胆酸的检测及临床意义

Determination of Lithocholic Acid in Intrahepatic Cholestasis of Pregnancy by High Performance Liquid Chromatography-Tandem Mass Spectrometry and Its Clinical Significance

目的:探讨石胆酸(LCA)在妊娠期肝内胆汁淤积症(ICP)患者血清中的水平及其与ICP病情程度的关系。方法:分别选取对照组、ICP轻度组、ICP重度组孕妇各20例,采用高效液相色谱串联质谱法检测孕妇血清中包括LCA在内的7种胆酸水平。结果:①对照组孕妇血LCA与轻度ICP组和重度ICP组比较,差异有统计学意义(P<0.05);轻度组孕妇血LCA与重度组比较,差异有统计学意义(P<0.05)。②对照组孕妇血LCA与ALT、AST、DBIL、TBA无相关性(P>0.05);轻度ICP组和重度ICP组孕妇血LCA与ALT、AST、DBIL、TBA有相关性(P<0.05)。结论:LCA水平在不同程度ICP孕妇血清中有差异,并且与ICP病情程度存在相关性,可能是引起ICP胎儿不良结局的原因之一。

Objective：To investigate the relationship between the concentrations of lithocholic acid（LCA） in serum and the severity of intrahepatic cholestasis of pregnancy（ICP）.Methods：Three groups were set up,including control group,mild ICP group and severe ICP group,20 pregnant women in each group.Seven kinds of bile acid including LCA in serum of all pragant women were checked by high performance liquid chromatography tandem mass spectrometry.Results：①LCA concentration in the serum of control group was significantly different with that in mild or severe ICP group（P〈0.05）.LCA in mild ICP group was markedly different with that in severe ICP group（P〈0.05）.②There was no correlation between maternal serum LCA and ALT,AST,DBIL,TBA in control group（P〈0.05）.While there was a positive correlation between maternal serum LCA and ALT,AST,DBIL,TBA in mild and severe ICP group（P〈0.05）.Conclusions：The serum LCA concentration is different in different severities of ICP,and it is correlated with the severity of disease.LCA might be one of the causes of poor fetal outcome in an ICP patient.