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目的:分析探讨各生化指标动态监测对妊娠期肝内胆汁淤积症早期预警的临床意义。方法:选取患妊娠期肝内胆汁淤积症孕妇和产科检查正常孕妇各50例进行生化指标动态监测。结果:ALT、AST、ALP、GGT、BIL等指标在早、中、晚各孕期两组间差别均有统计学意义(P<0.05),而TP和ALB整个孕周两组间差别无统计学意义(P>0.05)。ALT、AST、T-BIL、D-BIL在正常孕妇组早、中、晚孕期无差别(P>0.05),但在妊娠期肝内胆汁淤积症孕妇组差别有统计学意义(P<0.05)。通过ROC曲线分析,D-BIL/T-BIL在孕中期的诊断敏感性已经达到53%。结论:血清BIL水平对妊娠期肝内胆汁淤积症诊断意义不大,但D-BIL/T-BIL比值>0.35是妊娠期肝内胆汁淤积症重要特征之一,可以作为临床早期预警指标。
Objective: To analyze the clinical significance of dynamic monitoring of biochemical indexes in early warning of intrahepatic cholestasis of pregnancy. Methods: Fifty pregnant women with intrahepatic cholestasis of pregnancy and normal pregnant women were selected for biochemical monitoring. Results: The indexes of ALT, AST, ALP, GGT and BIL in the early, middle and late pregnancy were significantly different between the two groups (P <0.05), but there was no significant difference between the two groups Significance (P> 0.05). The levels of ALT, AST, T-BIL and D-BIL in normal pregnant women had no difference in early, middle and late pregnancy (P> 0.05), but there was significant difference in pregnant women with intrahepatic cholestasis of pregnancy (P <0.05) . By ROC curve analysis, D-BIL / T-BIL in the second trimester diagnostic sensitivity has reached 53%. Conclusion: Serum BIL level has little significance in the diagnosis of intrahepatic cholestasis of pregnancy, but the ratio of D-BIL / T-BIL> 0.35 is one of the most important features of intrahepatic cholestasis during pregnancy, which can be used as an early warning indicator in clinical practice.