TBA、CG及TNF-α在ICP产妇中的表达及在围产儿不良结局预测中的应用

TBA,CG,and TNF-αExpression in ICP parturients and its application in predicting adverse outcomes in perinatal infants

目的分析总胆汁酸(TBA)、血清甘胆酸(CG)及肿瘤坏死因子-α(TNF-α)在妊娠期肝内胆汁淤积症(ICP)中的表达及在围产儿不良结局预测中的应用价值。方法收集陕西省汉中市中心医院2019年10月—2021年12月收治的118例ICP患者的临床资料。另以同期入院104例健康分娩产妇作为对照组。比较二组TBA、CG及TNF-α水平变化;分析不同病情ICP产妇TBA、CG、TNF-α水平;并绘制ROC曲线分析上述因子预测ICP围产儿不良结局的价值。结果与健康组比较,ICP组TBA、CG及TNF-α水平更高(P<0.05)。ICP产妇TBA、CG及TNF-α水平:轻度组<中度组<重度组(P<0.05)。正常结局95例,不良结局23例,不良结局组TBA、CG及TNF-α水平明显高于正常结局组(P<0.05)。ROC结果示,TBA、CG及TNF-α单项检测曲线下面积(AUC)分别为0.680、0.713、0.694,TBA、CG及TNF-α联合检测AUC为0.861,明显较单独检测高。结论TBA、CG、TNF-α对于ICP病情评估及围产儿不良结局预后预测具有一定价值,且TBA、CG及TNF-α联合检测预测价值更高。

Objective To analyze total bile acid(TBA),serum glycocholic acid(CG),and tumor necrosis factor-αTumor crossing factor-α(TNF-α)Expression of intrahepatic cholestasis of pregnancy(ICP)and its application value in predicting adverse outcomes in perinatal infants.Methods The clinical data of one hundred and eighteen ICP patients admitted to Hanzhong Central Hospital in Shaanxi Province from October 2019 to December 2021 were collected.Another 104 cases of healthy parturient women who were admitted to hospital during the same period were taken as control group.TBA,CG and TNF-αlevels were compared between two groups.Levels of TBA,CG and TNF-αin ICP women with different conditions were analyzed.ROC curve was drawn to analyze value of these factors in predicting adverse outcomes of ICP perinatal infants.Results Compared with healthy group,ICP group showed TBA,CG,and TNF-αhigher levels from January 1,2020 to June 30,2023(P<0.05).The levels of TBA,CG and TNF-αin ICP pregnant women were as follows:mild grouP<moderate grouP<severe group(P<0.05).There were 95 cases with normal outcome and 23 cases with unfavorable outcome,the levels of TBA,CG and TNF-αin adverse outcome group were significantly higher than those in normal outcome group(P<0.05).ROC results showed that area under curve(AUC)of TBA,CG and TNF-αwere 0.680,0.713,0.694 respectively for single detection,and 0.861 for combined detection,and AUC of combined detection of TBA,CG and TNF-αwas 0.794,which was significantly higher than that of separate detection.Conclusion TBA,CG,TNF-αhas certain value in evaluating condition of ICP and predicting the prognosis of adverse outcomes in perinatal infants,and TBA,CG,and TNF-αJoint detection has higherpredictivevaluer.