妊娠期肝内胆汁淤积症发病机制及药物治疗进展

Pathogenesis and Drug Therapy Advance of Intrahepatic Cholestasis of Pregnancy

妊娠期肝内胆汁淤积症(intrahepatic cholestasis syndrome,ICP)是妊娠期特有的肝脏疾病,多发生于妊娠中晚期。ICP是临床上发生胎儿死亡的重要原因之一,但胎儿死亡风险与孕妇的疾病严重程度并无明显关系,以至于临床难以预测。孕妇发病后主要表现有皮肤瘙痒、肝酶和血清胆汁酸升高、皮肤抓痕等,少数孕妇可出现上腹部不适、恶心、呕吐、食欲缺乏、腹痛及轻度脂肪痢等症状。分娩后ICP各种临床表现迅速消失。目前临床对ICP的发病机制尚未明确,临床上难以采取有效的干预措施。因此了解ICP发病机制并进行早期诊治,对改善围产儿结局意义重大。本综述分析近期文献资料,总结ICP发病机制及药物治疗新进展。

ICP(intrahepatic cholestasis of pregnancy)is a special liver disease during pregnancy,which occurs in the mid-third trimester and is one of the important causes about fetal death in clinical practices.After the onset,the main symptoms of pregnant women after the onset are skin itching,elevated liver enzymes and serum bile acids,and skin scratches.A small number of pregnant women may experience upper abdominal discomfort,nausea,vomiting,lack of appetite,abdominal pain,and mild steatodysentery.After delivery,the various clinical symptoms of ICP disappeared quickly.the main symptoms of pregnant women were skin itching,elevated liver enzymes.At present,the clinical pathogenesis of the disease is not clear,it is difficult to take effective clinical intervention measures.Therefore,it is of great significance to understand the pathogenesis of ICP and make early diagnosis and treatment for it to improve the perinatal outcome.