妊娠期肝功能诊断中血清腺苷脱氨酶检测的应用价值

Application value of ADA for the diagnosis of liver function during pregnancy

目的探讨在妊娠肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)患者诊断中检测血清腺苷脱氨酶(adenosine deaminase,ADA)的临床应用价值。方法选择2012年1—10月在该院诊断为ICP的妊娠期患者30例作为观察组,选择同期在该院进行健康体检且体检合格的妊娠期孕妇30例作为对照组,分别检测两组血清标本的ADA活性,同时检测与肝功能相关的血清学指标丙氨酸氨基转移酶(ALT)、总胆汁酸(TBA)和总胆红素(TBIL)的水平,比较分析检测结果。结果观察组所有检测指标水平均明显高于对照组,差异有统计学意义(P<0.05);不同孕期的ICP患者血清ADA、ALT、TBA和TBIL的水平呈递增性升高,趋势呈正相关,但从各指标浓度升高趋势相关性来看,血清ADA的相关性明显优于其他血清学指标,差异有统计学意义(P<0.05)。结论血清ADA检测是ICP诊断的较敏感指标,可作为孕产妇筛查ICP的常规检测项目,具有较好的临床应用价值。

Objective To explore the application value of adenosine deaminase （ADA） for the diagnosis of intrahepatic cholestasis of pregnancy（ICP）. Methods 30 cases of ICP diagnosed in the hospital from January to October 2012 were selected as observation group, while 30 pregnant women with qualified physical in the hospital at the corresponding period for physical ex- amination were selected as control group. ADA activity in serum specimen of the two group was detected and observed respective- ly, simultaneously, serological indexes related to liver function including alanine aminotransferase （ALT）, total bile acid （TBA） and total bilirubin（TBIL） were detected. The detection results were compared and analyzed. Results The levels of the detection index- es in observation group were all obviously higher than those in the control group with statistically significant difference （P〈0.05） ; serum levels of ADA, ALT, TBA and TBIL of ICP patients in different pregnant time were in increasing trend with positive correla- tion, but, from the aspect of correlation of concentration rising trend of the indexes, the correlation of serum ADA was superior to other serological indexes and the difference had statistical signficanee（P〈0.05）. Conclusion Serum ADA is a quite sensitive in- dex for diagnosis of ICP,and it can be used as a routine detection index for ICP screening of pregnancies. Serum ADA has good clinical application value.