妊娠期肝内胆汁淤积症患者不良妊娠结局影响因素

Influencing factors of the adverse pregnancy outcomes of patients with intrahepatic cholestasis of pregnancy

目的:探究妊娠期肝内胆汁淤积症(ICP)患者不良妊娠结局可能影响因素。方法:收集2018年1月-2023年1月本院收治的225例ICP患者临床资料,收集患者基本信息、血液学指标等,随访12个月,采用logistic模型分析ICP患者不良妊娠结局影响因素;绘制受试者工作特征(ROC)曲线,评价影响因素预测ICP患者不良妊娠结局性能。结果:ICP患者不良妊娠结局发生率37.8%(85/225);多因素logistic回归分析,血清甘胆酸、总胆汁酸和白蛋白/碱性磷酸酶比值异常升高是ICP患者不良妊娠结局的独立影响因素;ROC曲线分析,血清甘胆酸(AUC=0.692)、总胆汁酸(AUC=0.713)、白蛋白/碱性磷酸酶比值(AUC=0.689)及3项联合(AUC=0.876)预测ICP患者不良妊娠结局均有一定效能。结论:血清甘胆酸、总胆汁酸、白蛋白/碱性磷酸酶比值异常升高均为ICP患者不良妊娠结局的独立影响因素,3项指标对不良妊娠结局均有一定预测效能。

Objective: To explore the possible influencing factors of the adverse pregnancy outcomes of patients with intrahepatic cholestasis of pregnancy(ICP). Methods: The clinical data of 225 patients with ICP admitted to the hospital from January 2018 to January 2023 were collected. The basic information and the hematological indicators values of the patients were collected, and the patients were followed up for 12 months. Logistic regression was used to analyze the possible influencing factors of the adverse pregnancy outcomes of the patients. Receiver operating characteristic(ROC) curve was plotted to evaluate the efficacy of the influencing factors for predicting the adverse pregnancy outcomes of the patients. Results: The incidence of the adverse pregnancy outcomes of the patients with ICP was 37.8%(85/225). Logistic regression analysis showed that the abnormally increased serum glycholic acid level and the total bile acid level and the albumin/alkaline phosphatase ratio of the patients with ICP were the independent influencing factors of their adverse pregnancy outcomes. ROC curve analysis showed that the area under the curve(AUC) of the serum glycholic acid level, the total bile acid level, the albumin/alkaline phosphatase ratio, and the combined the serum glycholic acid level, the total bile acid level and the albumin/alkaline phosphatase ratio of the patients with ICP for predicting their adverse pregnancy outcomes were 0.692, 0.713, 0.689 and 0.876, respectively. Conclusion: The abnormally increased serum glycholic acid level, the total bile acid level and the albumin/alkaline phosphatase ratio of the patients with ICP are the independent influencing factors of their adverse pregnancy outcomes, and which have certain efficacy for predicting the adverse pregnancy outcomes of the patients.