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目的分析脂代谢检测对妊娠期肝内胆汁淤积症(ICP)的临床应用价值。方法选取120例ICP患者、100例正常妊娠妇女分别为观察组与对照组,通过全自动生化分析仪对两组脂代谢、肝功能相关指标检测,同时通过酶联免疫吸附法(ELISA)测定两组雌激素,根据脂代谢情况将观察组分为正常组与异常组,分析血脂异常与雌激素、肝功能的关系及脂代谢异常对母婴妊娠结局的影响。结果与对照组比较,观察组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(apob)、雌二醇(E_2)、雌三醇(E_3)、直接胆红素(DBIL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆汁酸(TBA)水平均显著增高,高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(apoa-1)水平均显著降低,差异有统计学意义(t=8.198、10.842、10.928、11.724、19.214、5.735、12.083、21.376、23.199、25.060;11.869、8.998,P<0.05);观察组中血清脂代谢异常76例,正常44例,血清脂代谢异常组与正常组在E2、E3、DBIL、ALT、AST、TBA方面比较差异有统计学意义(t=10.338、7.654、17.549、16.875、13.003、10.456,P<0.05);多元线性回归分析显示TG、LDL-C、HDL-C水平上升与DBIL正相关;相比血清脂代谢正常组,异常组患者羊水污染、早产、宫内窘迫、新生儿并发症发生率均显著增高,差异有统计学意义(χ~2=8.041、15.596、12.013、15.596,P<0.05)。结论血清脂代谢指标对ICP预测有一定的价值,血脂代谢异常与肝功能改变是并列关系,ICP患者脂代谢异常易引发不良妊娠结局,为此需重视并加强妊娠妇女脂代谢、肝功能检测。
Objective To analyze the clinical value of detecting lipid metabolism in intrahepatic cholestasis of pregnancy (ICP). Methods 120 cases of ICP patients and 100 normal pregnant women were selected as the observation group and control group respectively. The lipid metabolism and liver function related indexes were detected by automatic biochemical analyzer. Group estrogen, according to the lipid metabolism of the observation group was divided into normal group and abnormal group, analysis of dyslipidemia and estrogen, liver function and lipid metabolism abnormalities on maternal and child pregnancy outcomes. Results Compared with the control group, the levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), apob, estradiol (E_3), direct bilirubin, ALT, AST and total bile acid (TBA) were significantly increased. The levels of high density lipoprotein cholesterol (HDL-C), apolipoprotein A1 (apoa-1) levels were significantly decreased, the difference was statistically significant (t = 8.198,10.842,10.928,11.724,19.214,5.735,12.083,21.376,23.199,25.060; 11.869,8.998, P <0.05); observation group There were 76 cases of abnormal serum lipid metabolism, 44 cases of normal, and there were significant differences in E2, E3, DBIL, ALT, AST and TBA between the serum lipid metabolism abnormal group and the normal group (t = 10.338,7.654,17.549,16.875, 13.003,10.456, P <0.05). Multiple linear regression analysis showed that the levels of TG, LDL-C and HDL-C were positively correlated with DBIL. Compared with the normal serum lipids group, the abnormal group had amniotic fluid contamination, preterm labor, intrauterine distress, Neonatal complications were significantly higher, the difference was statistically significant (χ ~ 2 = 8.041,15.596,12.013,15.596, P <0.05). Conclusion Serum lipid metabolism index has certain value for ICP prediction. Abnormal lipid metabolism and liver function change are paralleled. Abnormal lipid metabolism in ICP patients may lead to adverse pregnancy outcomes. Therefore, it is necessary to pay attention to and strengthen the detection of lipid metabolism and liver function in pregnant women.