不同分型ICP患者生化指标及围生结局分析

Analysis of Biochemical Indexes of Different Types of ICP Patients and Perinatal Outcome

目的探讨不同分型妊娠期肝内胆汁淤积症(ICP)患者的生化指标及围生结局,为临床诊治提供数据支持.方法筛选152名患者入组,按照病情程度进行分组,其中,轻型64例,重型88例,回顾性分析各组患者的生化指标、围生期内并发症和围生结局.结果轻型患者与重型患者相比,患者血清中的TBA,BIL水平更低,差异具有统计学意义(P<0.05);在围生期内发生羊水粪染、胎儿窘迫的概率也明显低(P<0.05);在围生结局方面早产率、剖宫产率也更低(P<0.01),与重型相比更难演变成重度ICP(P<0.05),且孕周也离足月更接近(P<0.05).结论比较血清中TBA,BIL值能提前发现潜在的ICP患者,通过早期预防和及时治疗避免轻型患者病情加重,提高围生结局.

Objective To investigate the biochemical indexes of different types of ICP （intrahepatic cholestasis of pregnancy） patients and the perinatal outcome to provide data for the clinical diagnosis and treatment. Method 152 hospitalized ICP patients were selected and grouped according to the severity of ICP, in which the mild patients were 64 cases and the severe patients were 88 cases. The biochemical indexes of patients, perinatal complications and perinatal outcome of patients in each group were analyzed retrospectively. Results Compared with those of the severe patients, TBA and BIL levels in the serum of the mild patients were lower, and the difference was statistically significant （ P 〈 0.05 ） ; in the perinatal period, the probability of fetal distress and meconium staining amniotic fluid was also significantly lower （P 〈 0.05 ）, the preterm delivery rate and cesarean section rate was significantly lower （P 〈 0.01 ） , which was not easy to become a severe ICP （P 〈 0.05 ）, and the gestational weeks were closer to the full-term （ P 〈 0.05 ）. Conclusion Potential ICP patients can be early discovered by comparing TBA and BIL values in serum, which is helpful in the early prevention and timely treatment to avoid the mild ICP to progress to a severe one and to improve the perinatal outcome.