餐后2小时血清甘胆酸测定对妊娠期肝内胆汁淤积症的早期诊断意义

The significance of postprandial 2 h of serum CG detection in the early diagnosis of intrahepatic cholestasis disease during pregnancy

目的探讨中孕期孕妇餐后2 h血清甘胆酸水平对妊娠期肝内胆汁淤积症的早期诊断意义。方法选取2013年1—12月来湖州市妇幼保健医院就诊的中孕期孕妇2272例,抽取其空腹血液和餐后2 h血液,检测其血清甘胆酸的水平,并对这些孕妇进行跟踪随访。结果 2272例孕妇随妊娠发展到晚期妊娠后发现94例出现不同程度的肝内胆汁淤积症,回顾分析发现,这94例肝内胆汁淤积症孕妇在中孕期的餐后2 h血清甘胆酸水平为(156.09±33.37)μg/dl,显著高于空腹血清甘胆酸水平(102.57±27.22)μg/dl(P<0.05);而其余2178例正常孕妇在中孕期的餐后2 h血清甘胆酸水平为(101.71±29.64)μg/dl,与同一天空腹血清甘胆酸水平的(97.85±24.58)μg/dl相比差异无统计学意义(P>0.05)。结论妊娠中期孕妇餐后2 h血清甘胆酸水平检测对妊娠期肝内胆汁淤积症的早期诊断具有重要意义,能在其未出现相应临床症状前作出诊断,使临床提前对肝内胆汁淤积症加以防范,进而降低孕妇肝内胆汁淤积症以及宫内窘迫的发病率。

Objective To investigative the significance of the detection of the postprandial 2 h of serum cholyglycine （CG） in the early diagnosis of intrahepatic cholestasis of pregnancy （ICP）. Methods Serum cholyglycine （CG） which extracted the fasting and postprandial 2 hour of whole blood were detected and analyzed in the 2272 pregnant women during midtrimester pregnancy from January 2013 to December 2013, and the 2272 cases of pregnant women were tracked simultaneously. Results 94 cases of the 2272 pregnant women were found with different degrees of intrahepatic cholesta- sis disease in the late pregnancy, and the 2 h serum CG in the 94 cases of intrahepatic cholestasis of pregnant women were higher than that of fasting serum CG in midtrimester pregnancy, there was significant differences at the same time （ P 〈 0.05 ） ;but the difference among 2178 cases of normal pregnant women was not significant （P 〉 0.05 ）. Conclusion The gallbladder of the pregnant women during midtrimester pregnancy contracted slightly, and had no corresponding clinical symptoms, but we could know the conditions of the gallbladder contraction by serum CG 2 hours after meal to prevent and reduce the incidence of pregnant women with intrahepatic cholestasis disease and fetal respiratory distress syndrome.