妊娠期肝内胆汁淤积症发病机制的研究进展

Research Progress in Pathogenesis of Intrahepatic Cholestasis during Pregnancy

妊娠期肝内胆汁淤积症(ICP)以皮肤瘙痒及黄疸为主要表现,也可无任何临床症状仅出现母体胆汁酸水平异常。ICP可诱发早产、胎儿窘迫、新生儿颅内出血等不良妊娠结局,甚至会发生无任何临床先兆的胎死宫内。有ICP病史的女性患肝脏和胆管疾病的风险较高,且曾患ICP的女性再次妊娠时更易复发ICP。目前我国关于ICP的诊断以母体血清胆汁酸为主要标准,同时需排除其他肝胆疾病或导致胆汁酸异常的相关疾病。临床治疗以对症治疗为主,目前尚无针对病因的治疗。基于ICP对母儿,尤其是胎儿造成的严重并发症,未来深入研究其发病机制尤为重要。

Intrahepatic cholestasis of pregnancy(ICP)is mainly manifested by pruritus and jaundice,and there are also cases with no clinical symptoms but only abnormal maternal bile acid levels.ICP can induce adverse pregnancy outcomes such as premature birth,fetal distress,and neonatal intracranial hemorrhage,and can even cause intrauterine fetal death without any clinical aura.Women with a history of ICP have a higher risk of liver and bile duct disease,and women who have previously had ICP are more likely to relapse with ICP in a second pregnancy.At present,the diagnosis of ICP in China takes maternal serum bile acid as the main standard,and other hepatobiliary diseases or related diseases leading to bile acid abnormalities should be excluded.The clinical treatment is mainly symptomatic treatment,and there currently is no treatment for the cause.Based on the serious complications caused by ICP to mothers and children,especially the fetus,it is particularly important to conduct in-depth study of its pathogenesis in the future.