血清总胆汁酸检测在孕妇肝内胆汁淤积症诊断中的应用价值

Application Value of Serum Total Bile Acid in Diagnosis of Intrahepatic Cholestasis of Pregnancy

目的探讨对不同妊娠期孕妇的血清总胆汁酸进行监测的临床应用价值。方法选取我院收治的患肝内胆汁淤积症的孕妇68例作为研究对象,分别对其血清总胆汁酸、丙氨酸氨基转移酶、门冬氨酸氨基转移酶的水平进行测定,并以60例正常妊娠的孕妇作为对照,行相同检测,比较两组孕妇各项指标检测结果之间的差异及异常检查率。同时按照孕妇的妊娠时间不同将其分为早孕期、中孕期和晚孕期三组,比较肝内胆汁淤积症孕妇在不同妊娠时间血清总胆汁酸检测结果的差异。结果肝内胆汁淤积症孕妇的TAB、ALT、AST检测水平、异常检出率均高于正常孕妇,差异有统计学意义(P<0.05)。随着妊娠时间的延长,孕妇血清总胆汁酸的水平均呈升高趋势,有孕晚期高于孕中期,同时高于孕早期的情况。结论孕妇在整个妊娠过程中会随着妊娠时间的延长出现血清总胆汁酸水平持续升高的情况,对其进行定期检测有利于妊娠性肝内胆汁瘀积症的早期发现与诊治,最大程度降低其对围产儿的不良影响。

Objective To investigate the clinical value of monitoring serum total bile acid in pregnant women of different pregnancy periods. Methods 68 cases of patients with intrahepatic cholestasis of pregnancy in our hospital were selected as the research object,the level of total bile acid,serum alanine aminotransferase and aspartate aminotransferase were determined,and 60 cases of normal pregnant women were taken as control group,and they were given the same test,the differences of the detection indexes in pregnant women between the two groups results and abnormal examination rate were studied. At the same time,they were divided into three groups according todifferent pregnant times ：early pregnancy,middle pregnancy and late pregnancy.Results Intrahepatic cholestasis of pregnancy TAB,ALT,AST detection level,abnormal detection rate were significantly higher than normal pregnant women,the difference was statistically significant（P〈0.05）. With the prolongation of pregnancy time,the serum total bile acid level of pregnant women showed an upward trend,and the late pregnancy was higher than that in the second trimester,which was higher than that in early pregnancy. Conclusion The level of serum total bile acid in pregnant women increases during the prolonged duration of pregnancy,its regular testing in early pregnancy is helpful for discovery and treatment of intrahepatic cholestasis,and to minimize the adverse effects on perinatal infants.