影响ICP围生儿不良结局潜在风险因素及其与BSEP基因多态性的关系研究

The potential risky factors incurring the bad outcomes of intrahepatic cholestasis of pregnancy

目的探讨影响妊娠期肝内胆汁淤积症围生儿不良结局的潜在风险因素。方法对该院2010年5月-2013年5月接受治疗的40例不良结局和46例良好结局的ICP患者进行病史记录搜集,对肝功能、血清总胆汁酸、胎儿监测结果以及BSEP基因等指标进行回顾性分析,并采用SPSS 18.0软件对搜集的数据进行独立样本t检验和χ2检验。结果两种结局患者的TBA,S/D值,NST值差异具有统计学意义,其他指标差异无统计学意义;不良结局组BSEP基因rs2287622位点C、T等位基因频率分别为83.75%和16.25%,良好结局组该位点C、T等位基因频率分别为66.30%和33.70%,两组间比较差异有统计学意义(P<0.05)。结论血清总胆汁酸水平以及脐血流(S/D)和胎心无负荷试验(NST)的检测结果是ICP围生儿出现不良结局的高危风险因素,也是很敏感的指标,对预测ICP围生儿是否产生不良结局具有很大的指导意义,BSEP基因rs2287622位点多态性(C/T)可能和妊娠期肝内胆汁淤积有关。

【Objective】To explore the potentially risky factors leading the bad outcomesof intrahepatic cholestasis of pregnancy. 【Methods】86 patients with the disease of intrahepatic cholestasis of pregnancywere treated in our hospital from May, 2010 to May, 2013, among whom 40 cases had bad outcomes, and 46 had good outcomes. Then retrospective analysis was done on the indicators such as liver function, glycocholic acid, and monitoring results of the fetus. At last, independent sample T-test and Chi-square test were done on the gathered data by means of spss18.0 software. 【Results】The value of TBA, S/D and NST had statistical difference, while the others had no big difference.【Conclusions】As the testing results show, total bile acid（TBA）, umbilical blood flow（S/D）, and nonestress test（NST） are not only the three high risky factors for bad outcomes of intrahepatic cholestasis of pregnancy but also sensitive indicators which have great guiding significance in predicting whether intrahepatic cholestasis of pregnancy will come out badly.