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目的探讨妊娠期肝内胆汁淤积症(ICP)患者血清胆碱酯酶(CHE)、腺苷脱氨酶(ADA)和总胆汁酸(TBA)水平变化及意义。方法采用OLYMPUS AU2700全自动生化分析仪检测28例ICP患者(试验组)和31例健康孕妇(正常组)血清标本中CHE和ADA活性以及TBA水平,检测肝功能相关的血清学指标丙氨酸氨基转移酶(ALT)、L-γ-谷氨酰基转移酶(GGT)和总胆红素(TBIL)的水平,对检测结果进行比较分析。所有统计分析由SPSS 19.0统计软件完成,组间比较采用完全随机设计的t检验或者完全随机设计的方差分析,P<0.05为差异有统计学意义。结果试验组孕早期患者血清CHE水平为(2 789±621)U/L,低于正常组,ADA和TBA水平分别为(26.1±5.2)U/L和(12.3±3.8)μmol/L,均高于正常组,差异均有统计学意义(P<0.05);孕中期患者血清CHE水平为(2 341±967)U/L,低于正常组,ADA、TBA、GGT和TBIL水平分别为(30.5±9.4)U/L、(15.6±8.7)μmol/L、(49.6±16.4)U/L和(30.2±8.6)μmol/L,均高于正常组,差异有统计学意义(P<0.05);孕晚期患者血清CHE水平为(1 658±1480)U/L,低于正常组,TBA、GGT、ADA、ALT和TBIL分别为(38.5±14.8)U/L、(23.5±14.9)μmol/L、(65.3±32.5)U/L、(72.3±24.7)U/L和(42.1±15.9)μmol/L,均高于正常组,差异有统计学意义(P<0.05)。结论血清CHE、ADA和TBA联合检测可作为孕产妇筛查ICP的常规检测项目,是评估ICP孕妇、胎儿宫内情况以及胆汁淤积程度等方面较为敏感检测指标。
Objective To investigate the changes of serum cholinesterase (CHE), adenosine deaminase (ADA) and total bile acid (TBA) in patients with intrahepatic cholestasis of pregnancy (ICP). Methods Serum samples of 28 patients with ICP (experimental group) and 31 healthy pregnant women (normal group) were tested for the activity of CHE and ADA and TBA by OLYMPUS AU2700 automatic biochemical analyzer. Serum alanine amino Transfected enzyme (ALT), L-γ-glutamyl transferase (GGT) and total bilirubin (TBIL) levels, the test results were compared and analyzed. All statistical analysis by SPSS 19.0 statistical software to complete the comparison between groups using a completely randomized t test or a completely randomized design analysis of variance, P <0.05 for the difference was statistically significant. Results Serum levels of CHE in the first trimester of the experimental group were (2 789 ± 621) U / L, which were lower than those in the normal group (26.1 ± 5.2 U / L and 12.3 ± 3.8 μmol / L, respectively (2 341 ± 967) U / L in the second trimester, which were lower than those in the normal group (P <0.05). The levels of ADA, TBA, GGT and TBIL were ( 30.5 ± 9.4) U / L, (15.6 ± 8.7) μmol / L, (49.6 ± 16.4) U / L and (30.2 ± 8.6) μmol / L, respectively, which were significantly higher than those in normal group ). Serum levels of CHE in the third trimester of pregnant women were (1 658 ± 1480) U / L, lower than those in the normal control group. TBA, GGT, ADA, ALT and TBIL were (38.5 ± 14.8) /L, (65.3 ± 32.5) U / L, (72.3 ± 24.7) U / L and (42.1 ± 15.9) μmol / L, respectively, which were significantly higher than those in the normal group (P <0.05). Conclusions Combined detection of serum CHE, ADA and TBA can be used as a routine test item for ICP screening of pregnant women and is a sensitive index for evaluating ICP pregnant women, intrauterine conditions and cholestasis.