妊娠期肝内胆汁淤积症脐动脉血流比值对新生儿预后的影响研究

Effect of umbilical arterial perfusion ratio on neonatal prognosis in intrahepatic cholestasis of pregnancy

目的探讨妊娠期肝内胆汁淤积症（ICP）脐动脉血流比值对新生儿预后的影响。方法选取2013年9月-2014年8月间该院收治的108例ICP孕妇为观察组；同时选取在该院健康体检的108例正常孕妇为对照组。对比两组孕妇肝功能指标：谷草转氨酶（AST）、谷丙转氨酶（ALT）、血清总胆汁酸（TBA）；围产儿结局：新生儿体重、早产、胎儿窘迫等；脐动脉血流检测指标：波动指数（PI值）、阻力指数（RI值）、血流收缩期和舒张期的比值（S／D值）。结果观察组患者AST、ALT、TBA水平均明显高于对照组，差异有统计学意义（P〈0．01）。观察组新生儿体重明显低于对照组，早产、胎儿窘迫、新生儿窒息等发生率明显高于对照组，差异均有统计学意义（P〈0．05）。观察组RI值和S／D值均明显高于对照组，差异有统计学意义（P〈0．01）；两组间PI值差异无统计学意义（P〉0．05）。结论ICP孕妇应定期检测脐动脉血流情况，便于尽早采取干预措施，改善围产儿结局。

Objective To investigate the effect of umbilical arterial perfusion ratio on neonatal prognosis in intrahepatic cholestasis of pregnancy （ICP） . Methods A total of 108 pregnant women with ICP from September 2013 to August 2014 in this hospital were selected as observation group; and 108 normal pregnant women for health examination in the hospital were selected as control group. Liver function indexes of pregnant women were compared between the two groups, including aspartate aminutransferase （AST）, alanine aminotransferase （ALT） , serum total bile acid （TBA） ; perinatal outcomes, including birth weight, premature delivery, fetal distress; umbilical artery blood flow detection indexes, including volatility index （PI value）, resistance index （RI value）, the ratio of blood flow systolic and diastolic （S/ D value） . Results In observation group, AST, ALT, and TBA levels were significantly higher than those in control group, the differences had statistical significance （ P〈0. 01 ） . Neonatal birth weight in observation group was significantly lower than that in control group, and the incidence rates of premature delivery, fetal distress, and neonatal asphyxia were significantly higher than those in control group, the differences had statistical significance （P〈0. 05） . RI value and S/D value in observation group were significantly higher than those in control group＇ with statistically significant difference （P〈0. 01 ） ; PI value between the two groups had no statistical significance （P〉0.05） . Conclusion ICP women should take periodic test of umbilical artery blood flow in order to take intervention and improve perinatal outcome.