妊娠期肝内胆汁淤积症总胆汁酸、雌三醇与新生儿Apgar评分的关系

Relationship between total bile acid and estriol of patients with intrahepatic cholestasis of pregnancy and neonatal Apgar score

目的研究妊娠期肝内胆汁淤积症(ICP)总胆汁酸、雌三醇与新生儿APgar评分的关系。方法收集2013年6月-2014年12月于该院就诊的ICP患者80例,所有患者均行肝功能生化指标及激素水平检测,对其新生儿均进行出生1 min时的APgar评价,应用单因素方差分析比较正常新生儿、中度窒息新生儿及重度窒息新生儿其母亲的血清胆汁酸和雌三醇情况的差异,采用多重线性回归分析患者血清胆汁酸和雌三醇与其产儿的新生儿Apgar评分的相关性。结果不同级别Apgar评分的新生儿相对应母亲的血清胆汁酸和雌三醇差异较大,P<0.01,差异具有统计学意义;建立回归方程发现CIP患者血清胆汁酸和雌三醇的回归系数t检验的P值均<0.05,具有统计学意义,总胆汁酸、雌三醇的标准回归系数分别-12.047、-2.473,说明其与新生儿的Apgar评分具有负相关性,且对于新生儿的Apgar评分中总胆汁酸对其影响更大。结论 ICP患者血清胆汁酸和雌三醇与其新生儿的Apgar评分呈现负相关性,ICP患者进行血清胆汁酸和雌三醇的检测对新生儿窒息有一定的预警作用。

Objective To research the relationship between total bile acid and estriol of patients with intrahepatic cholestasis of preg- nancy （ICP） and neonatal Apgar score. Methods Eighty ICP patients were collected from the hospital from June 2013 to December 2014, all the patients received liver function, biochemical indexes, and hormones levels detection, the neonates underwent one-minute Apgar scoring, univariate variance analysis was used to compare serum bile acid and estriol levels of mothers with normal neonates, moderate asphyxia neonates, and severe asphyxia neonates, multivariate linear regression analysis was used to analyze the correlation between maternal serum bile acid, estriol and Apgar score of neonates. Results There were statistically significant differences in maternal serum bile acid and estriol levels among the mothers with neonates of different Apgar score grades （ P〈0. 01 ） . Regression equation showed that there was .statistically significant difference in regression coefficients between serum bile acid and estriol in ICP patients （ P〈0. 05 ） ; the standard regression coeffi- cients of total bile acid and estriol were -12. 047 and -2. 473, respectively, which were negatively correlated with neonatal Apgar score, and the effect of total bile acid was greater. Conclusion Serum bile acid and estriol of ICP patients are negatively correlated with neonatal Apgar score, detection of serum bile acid and estriol has a certain warning effect for neonatal asphyxia.