脂质过氧化物对妊娠肝内胆汁瘀积症围产儿预后的影响

THE STUDY ON LIPID PEROXIDATE AND PERINATAL OUTCOME OF INTRAHEPATIC CHOLESTASIS DURING PREGNANCY

目的 :探讨脂质过氧化作用于ICP围产儿预后的关系。方法 :分别用硫代巴比妥酸荧光测定法和邻苯三酚自氧法测定同期正常晚期妊娠妇女 10 2例 (对照组 )及妊娠期肝内胆汁瘀积症 (ICP)患者 12 6例 (观察组 )的血浆和脐静脉血脂质过氧化物 (LPO)和红细胞超氧化物歧化酶 (RBC -SOD)活性 ;比较新生儿出生体重、Apgar评分和羊水状况。结果 :①ICP组宫内发育迟缓 (IUGR)、羊水异常和新生儿窒息率均明显高于对照组 (P均 <0 0 1)。②ICP组母儿血LPO浓度均明显高于对照组 (P 均 <0 0 1) ;母血RBC -SOD活性明显高于对照组 ( P<0 0 1) ,脐血RBC -SOD活性与对照组无显著性差异 ( P >0 0 5)。③在ICP组 ,IUGR、新生儿窒息和羊水异常时 ,脐血LPO浓度均明显增高 ,而脐血RBC～SOD活性均明显下降。④ICP组脐血LPO与新生儿出生体重和Apagr评分呈明显负相关 (γ =-0 584 ,P <0 0 1;γ =-0 4 75,P <0 0 5)。结论 :脂质过氧化物对ICP的IUGR。

Objective:To study the relationship of Lipid Peroxidation and Perinatal outcome of intrahepatic cholestasis during pregnancy(ICP). Methods:In 126 ICP and 102 control group,maternal plasma and umbilical cord vein concentration of Lipid peroxidate(LPO) and the amount of superoxide dismutase in red blood cell (RBC-SOD) were measured by thiobarbituric acid fluorimetric determination and catechol self-oxidation determination respectively.Fetal outcomes were assessed by the neonatal weight at delivery,Apgar scores and the quality and quantity of amniotic fluid. Results:①The rate of the abnormal quality and quantity of amniotic fluid,the intrauterine growth retardation (IUGR) and neonatal asphxia in the ICP group were significantly higher than those in the control group ( P <0 01, P <0 01, P <0 01).②Maternal plasma and umbilical cord vein levels of LPO in the ICP group were significantly higher than those in the control group( P <0 01, P <0 01).Maternal plasma level of RBC-SOD in the ICP group was significantly higher than that in the control group ( P <0 01).There was no significant difference in the level of RBC-SOD of umbilical cord vein between the ICP group and the control group( P >0 05).③In the ICP group ,umbilical cord vein level of LPO in the subgroup of adverse perinatal outcomes was significantly higher than that in the subgroup of good perinatal outcomes,and the level of RBC-SOD was significantly lower.④There was a negative correlation between LPO of umbilical cord vein and the neonatal weight at delivery and Apgar scores in the ICP group(γ= -0 584, P <0 01; γ= -0 475, P <0 05 ).Conclusions:Lipid peroxidation has significant relationship with adverse perinatal outcomes in the ICP.