妊娠期肝内胆汁淤积症血脂变化及其临床意义

Changes of blood lipid in intrahepatic cholestasis of pregnancy and its clinical significance

目的探讨妊娠期肝内胆汁淤积症（ICP）患者血脂变化及其临床意义。方法收集2010-2011年在该院分娩的49例妊娠晚期ICP患者（ICP组）和50例健康孕妇（对照组）的空腹血清,测定血脂指标并进行比较。将ICP组患者分为血脂正常组（15例）和血脂异常组（34例）,观察两组患者肝功能变化。结果 （1）ICP组患者总胆固醇、三酰甘油、低密度脂蛋白均高于对照组,高密度脂蛋白低于对照组,差异均有统计学意义（P〈0.05）;（2）血脂异常组患者丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、总胆红素及结合胆红素均高于血脂正常组,清蛋白低于血脂正常组,羊水污染及新生儿并发症发生率高于血脂正常组,差异均有统计学意义（P〈0.05）。结论 ICP患者血脂异常有别于妊娠期生理性血脂改变,能反映病情严重性,应作为ICP患者的重要监测指标。

Objective To explore the changes of blood lipid in intrahepatic cholestasis of pregnancy（ICP） patients and its clinical significance. Methods Collected empty stomach serum of 49 ICP patients in third trimester of pregnancy （ICP group） and 50 healthy pregnant women （control group ） who gave birth in this hospital from 2010 to 2011. Measured and compared their blood lipid parameter. Divided ICP group＇s patients into normal blood lipid group and abnormal blood lipid group, and observed their liver function change. Results （1） ICP group＇s total cholesterol,triacylglycerol and low density lipoprotein were all higher than control group＇s while the high density lipoprotein was lower, differences showing statistical significance （P〈0.05）. （2）Abnormal blood lipid group＇s alanine aminotransferase ,aspartic transaminase amino acids, total bilirubin and direct bilirubin were all higher than normal blood lipid group＇s, while the albumin was lower, and the amniotic fluid pollution and newborn complication＇s incidence rate were higher, differences showing statistical significance （P〈0.05）. Conclusion The abnormal blood lipid of ICP patients is different from physiologic change of blood lipid during gestation period. It reflects the severe state of the illness and should be ICP patients＇ important monitoring index.