孕产妇转氨酶升高的临床分析

Clinical analysis of transaminase elevation on pregnant woman

目的探讨孕产妇转氨酶升高的相关性。方法回顾性分析本院2011年12月～2012年12月收治的142例门诊查体正常育龄期妇女和244例孕产妇的临床资料对其血清中的谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、碱性磷酸酶(ALP)和总胆汁酸(TBA)进行检测分析。结果转氨酶正常孕妇与育龄期妇女血清中的TBIL、TBA含量的差异无统计学意义(P>0.05),ALT差异有统计学意义(P<0.01);转氨酶正常孕妇与转氨酶升高孕妇血清中的TBIL、TBA和ALT的含量差异有统计学意义(P<0.05)。孕产妇转氨酶升高时,TBIL、TBA的升高到达21.7%、61.4%,所有孕妇ALP均升高,因而孕产妇转氨酶升高与TBA的升高有较高的相关性。结论在排除了肝原发性疾病、妊娠高血压综合征及其他的器质性病变后,如果孕产妇没有皮肤瘙痒与黄疸,而转氨酶升高并伴有TBA明显升高者,可以诊断早期妊娠期肝内胆汁淤积症。由于所有孕产妇ALP均升高,所以ALP对妊娠期肝内胆汁淤积症的诊断无特异性。

Objective To explore the correlation analysis of transaminase elevation on pregnant woman. Methods A retrospective analyzed the clinical date of 142 childbearing age women with normal physical examination in clinic and 244 cases of pregnant women who were treated in our hospital from December 2011 to December 2012. The serum alanine aminotransferase （ALT）,aspartate aminotransferase （AST）,total bilirubin （TBIL）,alkaline phosphatase （ALP） and total bile acid （TBA） were detected and analyzed. Results The serum TBIL and TBA content in pregnant women with normal transaminase and childbearing age women had no significant difference （P〉O.O5）,ALT had significant difference （P〈0.01）.The TBIL,TBA and ALT .content in pregnant women with normal and elevatory transaminase all had significantly difference （P〈0.05）.And when transaminase elevated in pregnant women,TBIL and TBA increased to 21.7% and 61.4%,and ALP in all pregnant women increased.Thus transaminase elevation in pregnant women had a higher correlation with TBA elevation. Conclusion In the exclusion of primary hepatic disease,pregnancy-induced hypertension and other organic disease,if pregnant women had transaminase elevation associated with TBA elevation significantly without pruritus and jaundice,it can be diagnosed as early ICP.Because ALP increased in all the pregnant women,ALP has no specificity in the diagnosis of ICP.