妊娠期肝内胆汁淤积症胆汁酸对新生儿并发症及预后的影响

The influence of bile acid in patients with intrahepatic cholestasis of pregnancy on neonatal complications and prognosis

目的探讨妊娠期肝内胆汁淤积症胆汁酸对新生儿并发症及预后的影响。方法选取2012年1月~2014年1月入院治疗的68例妊娠期肝内胆汁淤积症孕妇为肝内胆汁淤积症组,同期正常孕妇68例为健康对照组。观察比较两组孕妇胆汁酸、丙氨酸氨基转移酶,新生儿的胎龄、出生质量和宫内窘迫的发生率。结果肝内胆汁淤积症组孕妇的胆汁酸和丙氨酸氨基转移酶水平均高于健康对照组,差异有统计学意义（t=13.0045,P=0.0000;t=7.2784,P=0.0000）;肝内胆汁淤积症组新生儿的胎龄和出生质量均明显低于健康对照组,差异有统计学意义（t=21.1026,P=0.0000;t=16.6681,P=0.0000）;肝内胆汁淤积症组宫内窘迫发生率高于健康对照组,差异有统计学意义（χ^2=4.1676,P=0.0412）。结论妊娠期肝内胆汁淤积症孕妇的胆汁酸水平显著升高,可导致宫内窘迫发生率升高,新生儿胎龄短、出生质量低,整体预后效果不佳。

Objective To explore the influence of bile acid in patients with intrahepatic cholestasis of pregnancy on neonatal complications and prognosis. Methods 68 cases of pregnant women with intrahepatic cholestasis of pregnancy in our hospital from January 2012 to January 2014 were selected as intrahepatic cholestasis of pregnancy group,68 normal pregnant women at the same time were selected as healthy control group.The bile acid,alanine aminotransferase,neonates with gestational age,neonatal birth quality and the incidence of fetal distress of the two groups was observed and compared. Results The level of bile acid and alanine aminotransferase in the intrahepatic cholestasis of pregnancy group was higher than that in the healthy control group,the difference was significance（t=13.0045,P=0.0000;t=7.2784,P=0.0000）.The level of neonates with gestational age and neonatal birth quality in the intrahepatic cholestasis of pregnancy group was lower than that in the healthy control group,the difference was significant（t =21.1026,P =0.0000;t =16.6681,P =0.0000）.The incidence of fetal distress in the intrahepatic cholestasis of pregnancy group was higher than that in the healthy control group,the difference was significant（χ^2=4.1676,P=0.0412）. Conclusion The bile acid level of pregnant women with intrahepatic cholestasis of pregnancy increases significantly,which can lead to higher incidence of intrauterine distress,neonatal has shorter gestational age and lower birth quality,the overall prognosis is poor.