子痫前期对妊娠期肝内胆汁淤积症患者血液生化指标及妊娠结局的影响

Effect of preeclampsia on blood biochemical parameters and pregnancy outcome in patients with intrahepatic cholestasis of pregnancy

目的:探究子痫前期(PE)对妊娠期肝内胆汁淤积症(ICP)患者血液生化指标及妊娠结局的影响。方法:选取本院2016年1月~2018年1月期间收治的ICP患者180例,其中45例合并PE的患者标记为观察组,其余135例ICP患者标记为对照组。比较两组患者肝功能指标、血清炎症因子指标水平以及妊娠结局和新生儿结局之间的差异。结果:观察组患者肝功能指标[丙氨酸转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转肽酶(GGT)、总胆酸(TBA)、总胆红素(TBIL)]水平均明显高于对照组,差异均有统计学意义(P<0.01)。观察组患者血清白细胞介素12(IL-12)及肿瘤坏死因子-α(TNF-α)以及细胞因子信号传导负调控因子-3(SOCS-3)水平均明显高于对照组,差异均有统计学意义(P<0.01)。观察组患者分娩孕周[(36.89±0.55)周]明显短于对照组[(38.68±0.59)周],差异有统计学意义(t=18.56,P=0.00);观察组患者剖宫产率、羊水过多率均明显高于对照组,差异均有统计学意义(P<0.01)。观察组患者新生儿体重[(3.05±0.32)kg]明显低于对照组[(3.39±0.45)kg],差异有统计学意义(t=5.53,P=0.00);观察组患者早产率、胎儿窘迫率、新生儿窒息率均明显高于对照组,差异均有统计学意义(P<0.05)。结论:子痫前期可加重妊娠期肝内胆汁淤积症患者肝功能损害及血清炎症因子指标水平紊乱,是妊娠结局、新生儿结局的重要危险因素,值得在临床诊治中关注。

Objective: To investigate the effects of pre-eclampsia (PE) on blood biochemical parameters and pregnancy outcomes in patients with intrahepatic cholestasis of pregnancy (ICP). Methods : The study subjects selected 180 patients with ICP who were admitted to our hospital from January 2016 to January 2018.Among them,45 patients with PE were marked as observation group,and the remaining 135 patients with ICP were labeled as control group.The liver function indicators,serum inflammatory factor index levels,and differences between pregnancy outcomes and neonatal outcomes were compared between the two groups. Results: The liver function indexes (ALT,AST,GGT,TBA,TBIL) in the observation group were significantly higher than those in the control group,and the differences were statistically significant ( P <0.01).The levels of serum IL-12,TNF-α and SOCS-3 in the observation group were significantly higher than those in the control group,and the differences were statistically significant ( P <0.01).The gestational weeks (36.89±0.55) of the observation group were significantly shorter than the control group (38.68±0.59),and the difference was statistically significant ( t =18.56, P =0.00).The cesarean section rate and amniotic fluid rate in the observation group were observed.They were significantly higher than the control group,and the differences were statistically significant ( P <0.01).The neonatal weight of the observation group (3.05±0.32) was significantly lower than that of the control group (3.39±0.45),and the difference was statistically significant ( t =5.53, P =0.00).The premature birth rate,fetal distress rate,neonate in the observation group The asphyxiation rate was significantly higher than that of the control group,and the difference was statistically significant ( P <0.05). Conclusion: Preeclampsia can aggravate liver function damage and serum inflammatory factor levels in patients with intrahepatic cholestasis of pregnancy.It is an important risk factor for pregnancy outcome and neonatal outcome,and it is worthy of attention in clinical diagnosis and treatment.