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目的:调查分析南通地区妊娠期肝内胆汁淤积症发病情况及其相关发病因素,为临床诊治提供依据。方法:搜集2011年1月至2015年12月南通地区住院孕妇的资料,统计妊娠期发现肝功能异常的病例数,分析其中妊娠期肝内胆汁淤积症患者所占比例,同时分析妊娠期肝内胆汁淤积症与年龄、孕前体重指数、胎次、不良妊娠史(自然流产或早产)、家族史、饮食、受精方式、激素保胎治疗、自身免疫性疾病、妊娠期高血压、妊娠期糖脂代谢异常等情况的相关性。结果:99 523例妊娠晚期孕妇中,肝损害3 712例(发病率为3.73%),其中妊娠期肝内胆汁淤积症998例(占26.89%)。单因素分析发现单胎及双胎以上妊娠、家族史、人工受精、激素保胎治疗、自身免疫性疾病、妊娠期高血压、妊娠期糖脂代谢异常与妊娠期肝内胆汁淤积症发病相关,进一步行多因素非条件Logistic回归分析结果显示,双胎以上妊娠、家族史、激素保胎治疗、自身免疫性疾病、妊娠期高血压是妊娠期肝内胆汁淤积症发病的危险因素,OR值分别为5.25、2.06、4.01、5.21、2.01,差异有统计学意义(P<0.05)。结论:南通地区妊娠期肝内胆汁淤积症发病率较高,双胎及以上妊娠、家族史、激素保胎治疗、自身免疫性疾病、妊娠期高血压是其危险因素,在妊娠期肝内胆汁淤积症诊治中应引起重视。
Objective: To investigate the incidence of intrahepatic cholestasis of pregnancy and the related risk factors in Nantong area, and provide evidence for clinical diagnosis and treatment. Methods: The data of hospitalized pregnant women in Nantong from January 2011 to December 2015 were collected. The number of cases with abnormal liver function during pregnancy was collected. The proportion of patients with intrahepatic cholestasis of pregnancy was analyzed. The intrahepatic Cholestasis with age, pre-pregnancy body mass index, parity, history of adverse pregnancy (spontaneous abortion or premature birth), family history, diet, fertilization, hormone homeostasis, autoimmune disease, gestational hypertension, gestational glycolipids Metabolic abnormalities such as the relevance of the situation. Results: Among 99 523 pregnant women with late pregnancy, 3 712 liver damage occurred (the incidence was 3.73%), of which 998 were intrahepatic cholestasis of pregnancy (26.89%). Univariate analysis found that singleton and twin pregnancy or more, family history, artificial insemination, hormone tocolytic therapy, autoimmune diseases, gestational hypertension, abnormal gestational glucose and lipid metabolism associated with intrahepatic cholestasis of pregnancy incidence, Further analysis of multivariate non-conditional Logistic regression analysis showed that gestational hypertension, pregnancy history, family history, hormone homeostasis, autoimmune disease and gestational hypertension were the risk factors of intrahepatic cholestasis of pregnancy 5.25,2.06,4.01,5.21,2.01, the difference was statistically significant (P <0.05). Conclusion: The incidence of intrahepatic cholestasis in pregnancy is high in Nantong area. Pregnancy with twins and above, family history, hormone miscarriage treatment, autoimmune diseases and gestational hypertension are the risk factors. Intrahepatic cholestasis of pregnancy Sediment disease should pay attention to the diagnosis and treatment.