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目的探讨妊娠期肝内胆汁淤积症(ICP)患者血清总胆汁酸(TBA)和肝功能的改变特点,分析其临床意义。方法收集50例ICP患者和50名正常妊娠女子空腹血清,测定血清TBA含量,同时检测血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(GGT),观察ICP患者血清TBA和肝功能异常与母儿并发症及妊娠结局的关系。结果 ICP组血清TBA(73.9±13.6)μmmol/L,显著高于对照组(7.8±2.1)μmol/L,(P<0.01);ICP组血清ALT和AST及GGT分别为(98.5±6.8)U/L和(84.2±5.6)U/L及(143.9±14.7)U/L,显著高于对照组(32.5±5.1)U/L和(25.3±5.2)U/L及(35.1±4.5)U/L,(P均<0.01)。ICP患者肝功能及血清TBA值异常,可使孕妇自觉症状加重,倒置胎儿宫内窘迫,胎儿宫内发育迟缓,早产,产时并发症等。结论血清TBA和肝功能是敏感的指标,反映了病情的严重性,对ICP的临床诊断,疗效判断及病情发展有重要参考价值,可进一步提高了我们对ICP的认识。
Objective To investigate the changes of serum total bile acid (TBA) and liver function in patients with intrahepatic cholestasis of pregnancy (ICP) and to analyze its clinical significance. Methods Fasting serum was collected from 50 ICP patients and 50 normal pregnant women. Serum TBA levels were measured. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transferase Peptidase (GGT), to observe the relationship between serum TBA, liver dysfunction and maternal complications and pregnancy outcome in ICP patients. Results Serum TBA (73.9 ± 13.6) μmmol / L in ICP group was significantly higher than that in control group (7.8 ± 2.1) μmol / L, (P <0.01). The levels of serum ALT and AST and GGT in ICP group were (98.5 ± 6.8) U / (84.2 ± 5.6) U / L and (143.9 ± 14.7) U / L were significantly higher than those in control group (32.5 ± 5.1) U / L and (25.3 ± 5.2) U / L and (35.1 ± 4.5) U / L, (P <0.01). ICP patients with abnormal liver function and serum TBA, pregnant women can increase the symptoms, inverted fetal distress, intrauterine growth retardation, premature birth, birth complications and so on. Conclusion Serum TBA and liver function are sensitive indicators, reflecting the seriousness of the disease. It has important reference value for the clinical diagnosis, curative effect judgment and progression of ICP, which can further improve our understanding of ICP.