不同孕周发病的妊娠期肝内胆汁淤积症患者血清TBA、ALT、AST特点及围产儿结局分析

The Characteristics of Serum TBA、ALT、AST in Patients with Intrahepatic Cholestasis of Pregnancy in Different Gestational Weeks and Analysis of Perinatal Outcome

目的分析不同孕周发病的妊娠期肝内胆汁淤积症(ICP)患者血清生化指标血清总胆汁酸(TBA)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)以及总胆红素(TBIL)的表达水平差异和妊娠结局。方法回顾性将2018年3月至2019年11月在我院接受治疗的83例ICP患者纳入研究,根据不同孕周发病时间分为两组,将孕周<28周起病的46例患者作为早发型ICP组,将孕周≥28周起病的37例患者作为晚发型ICP组。所有患者接受生化检验观察各项血清生化指标水平变化情况;调查两组患者妊娠结局。结果两组患者ALT、AST以及TBIL比较,差异无统计学意义(P>0.05),早发型ICP组患者TBA明显高于晚发型ICP组患者,差异有统计学意义(P<0.05);早发型ICP组的早产率、羊水粪染率、剖宫产率明显高于晚发型ICP组患者,差异有统计学意义(P<0.05);晚发型ICP组新生儿出生体质量和分娩孕周均明显高于早发性ICP组比较,差异有统计学意义(P<0.05)。结论早发型ICP组患者其血清生化指标明显更高,同时出现不良妊娠结局的几率更大,值得临床重点关注。

Objective To analyze the serum biochemical parameters of serum total bile acid(TBA),alanine aminotransferase(ALT),aspartate aminotransferase(AST),and total bilirubin(TBIL)in patients with intrahepatic cholestasis of pregnancy(ICP)during different gestational weeks,and to compare the pregnancy outcomes.Methods 83 ICP patients treated in our hospital from March 2018 to November 2019 were included in the study and divided into two groups according to different onset times of gestational age.46 patients with onset of disease<28 weeks of gestational age were selected as early onset ICP group,and 37 patients with onset of disease≥28 weeks of gestational age were selected as late onset ICP group.All patients underwent biochemical tests to observe the changes of above mentioned serum biochemical indexes.The pregnancy outcome of the two groups was investigated.Results There were no significant differences in ALT,AST and TBIL between the two groups(P>0.05).TBA in the early-onset ICP group was significantly higher than that in the late-onset ICP group(P<0.05).The rate of premature delivery,fecal contamination in amniotic fluid and cesarean section in early type ICP group were significantly higher than those in late type ICP group(P<0.05).The neonatal birth weight and gestational age in the late onset ICP group were significantly higher than those in the early onset ICP group(P<0.05).Conclusion The serum biochemical indexes of patients and the incidence of adverse pregnancy outcomes in the early onset ICP groups were significantly higher,which deserves clinical attention.