妊娠期肝内胆汁淤积症患者胆汁酸水平与凝血功能相关性分析

Analysis of the correlation between bile acid level and coagulation function in patients with intrahepatic cholestasis of pregnancy

目的:分析妊娠期肝内胆汁淤积症(ICP)患者的血清总胆汁酸(TBA)水平与凝血功能的相关性。方法:收治正常晚期妊娠妇女40例和妊娠期肝内胆汁淤积症患者73例(重度30例,轻度43例),根据TBA水平分为轻度组、重度组及对照组,观察三组TBA值与凝血功能指标以及产后出血量的相关性。结论:轻度ICP组的纤维蛋白(FIB)、D-二聚体(D-D)、产后出血量明显高于对照组,差异有统计学意义(P<0.05);重度ICP组FIB、D-D及产后出血量均明显高于对照组及轻度组,PLT明显低于对照组及轻度组,差异有统计学意义(P<0.05)。FIB、D-D、出血量与血清TBA水平呈正相关。结论:ICP孕妇体内存在异常凝血及纤溶状态,易导致产后出血,临床应高度重视,积极诊治,改善不良妊娠结局。

Objective:To analyze the correlation between bile acid level and coagulation function in patients with intrahepatic cholestasis of pregnancy(ICP).Methods:40 cases of normal late pregnancy women and 73 cases of intrahepatic cholestasis of pregnancy(severe in 30 cases,mild in 43 cases)were selected.According to the level of bile acid,they were divided into the mild group,the severe group and the control group.The correlation of bile acid value with coagulation function and postpartum hemorrhage was observed.Results:The amount of FIB, D-D and postpartum hemorrhage in mild ICP group was significantly higher than that in control group(P<0.05).The amount of FIB,D-D and postpartum hemorrhage in the severe ICP group was significantly higher than that in the control group and the mild group, the difference was statistically significant(P<0.05),and PLT was significantly lower than that in the control group and the mild group,the difference was statistically significant(P<0.05).FIB, D-D and blood loss were positively correlated with serum bile acid.Conclusion:There are abnormal coagulation and fibrinolysis in ICP pregnant women,which can easily lead to postpartum hemorrhage.Clinical attention should be paid to actively diagnosis and treatment to improve adverse pregnancy outcomes.