妊娠期肝内胆汁淤积症患者脐血瘦素水平及临床意义

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目的探讨ICP患者脐血瘦素水平的变化及其临床意义。方法随机选取住院病人42例,其中ICP孕妇30例和正常孕妇12例,ICP患者按不同分度、不同孕周及羊水胎粪污染有无分类。采用放射免疫法检测脐静脉血瘦素水平。数据用SPSS16.0统计软件分析。结果(1)15例轻度ICP组、15例重度ICP组与正常组的脐血瘦素水平,三组比较无明显差异(P>0.05)。正常组脐血瘦素水平与新生儿体重呈明显正相关(r=0.678、P=0.015),但ICP组无相关性(P>0.05)。(2)ICP早产组17例、足月产组13例,ICP足月产组脐血瘦素水平较其早产组、正常组增高,差异有显著性(P<0.05)。ICP早产组与正常组比较无显著差异(P>0.05)。正常组、ICP组的脐血瘦素水平与各不同孕周无相关性(P>0.05)。(3)ICP合并羊水污染组13例、无羊水污染组17例,两组脐血瘦素水平比较无明显差异(P>0.05)。Apgar评分差异无显著性(P>0.05)。结论ICP患者脐血瘦素水平增高是机体适应缺氧以满足胎儿宫内生长需求而发生的一种代偿性反应,对胎儿有促进作用,可能是胎儿安全的信号,一旦失代偿导致胎儿生长受限。 Objective To investigate the changes of cord blood leptin in ICP patients and its clinical significance. Methods Forty-two inpatients were enrolled in this study, including 30 pregnant women with ICP and 12 normal pregnant women. ICP patients were classified according to different sub-degrees, gestational weeks and amniotic fluid meconium-stained. Using radioimmunoassay to detect umbilical venous blood leptin level. Data using SPSS16.0 statistical software analysis. Results (1) The levels of cord blood leptin in 15 mild ICP group and 15 severe ICP group and normal group were not significantly different among the three groups (P> 0.05). The level of cord blood leptin in normal group was positively correlated with the weight of newborn (r = 0.678, P = 0.015), but there was no correlation in ICP group (P> 0.05). (2) There were 17 cases in ICP preterm group and 13 cases in term group. The level of umbilical serum leptin in ICP full-term group was higher than that in preterm group and normal group (P <0.05). ICP preterm group compared with the normal group no significant difference (P> 0.05). Cord blood leptin level in normal group and ICP group had no correlation with different gestational weeks (P> 0.05). (3) There were 13 cases of ICP combined with amniotic fluid contamination and 17 cases of no amniotic fluid contamination. There was no significant difference in cord blood leptin levels between the two groups (P> 0.05). Apgar score difference was not significant (P> 0.05). Conclusion Increased umbilical cord blood leptin level in ICP patients is a compensatory reaction that the body adapts to hypoxia to meet the needs of intrauterine growth and has a promoting effect on the fetus, which may be a signal of fetal safety. Once the decompensation causes the fetus Growth is limited.
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