肝功能与雌三醇预测肝内胆汁淤积症孕妇妊娠结局的价值

Value of liver function and estriol in predicting pregnancy outcome in pregnant women with intrahepatic cholestasis

目的探讨肝功能与雌三醇预测肝内胆汁淤积症孕妇妊娠结局的价值。方法选取2017年1月至2018年12月在本院妇产科收治,23例妊娠期肝内胆汁淤积症孕妇作为研究组,另选择23例随机抽取的妊娠期正常孕妇作为对照组。对两组孕妇的肝功能[血清甘胆酸(cholyglycine,CG)与总胆汁酸(total bile acid,TBA)]及游离雌三醇(unconjugated E3,uE3)水平进行检测,并比较两组孕妇检测结果数据和不良妊娠结局(胎儿窘迫、早产、新生儿窒息和新生儿死亡)发生情况。结果研究组孕妇血清的CG、TBA以及uE3的平均水平明显高于对照组,两组比较差异有统计学意义(P<0.05)。研究组孕妇的胎儿窘迫和新生儿窒息发生率明显高于对照组,两组比较差异有统计学意义(P<0.05)。两组孕妇早产、新生儿死亡率比较差异无统计学意义。结论肝功能和雌三醇水平升高会导致孕妇患上妊娠期肝内胆汁淤积症,及早检测肝功能和雌三醇有利于降低不良妊娠结局的发生率,具有良好的临床实用价值。

Objective To explore the value of liver function and estriol in predicting pregnancy outcome of pregnant women with intrahepatic cholestasis.Methods From January 2017 to December 2018,23 pregnant women with intrahepatic cholestasis of pregnancy were selected as study group,and 23 normal pregnant women were selected as control group.The liver function [serum cholyglycine (CG) and total bile acid (TBA)] and free estriol (uE3) levels of the two groups of pregnant women were detected.The results of the two groups were compared with the incidence of adverse pregnancy outcomes (fetal distress,premature birth,neonatal asphyxia and neonatal death).Results The average levels of serum CG,TBA and uE3 in the study group were significantly higher than those in the control group,and the difference between the two groups was statistically significant (P<0.05).The incidence of fetal distress and neonatal asphyxia in the study group was significantly higher than that in the control group,and the difference between the two groups was statistically significant (P<0.05).There was no significant difference in premature delivery and neonatal mortality between the two groups.Conclusion Elevated liver function and estriol levels can lead to intrahepatic cholestasis of pregnancy.Early detection of liver function and estriol can reduce the incidence of adverse pregnancy outcomes and has good clinical value.