中国现代医生
中國現代醫生
중국현대의생
CHINA MODERN DOCTOR
2014年
20期
1-4
,共4页
妊娠期肝内胆汁淤积症%总胆汁酸%围产儿%妊娠预后%胎儿损伤
妊娠期肝內膽汁淤積癥%總膽汁痠%圍產兒%妊娠預後%胎兒損傷
임신기간내담즙어적증%총담즙산%위산인%임신예후%태인손상
Intrahepatic cholestasis of pregnancy%Total bile acids%Perinatal infant%Pregnancy outcomes%Fetal damage
目的：探讨早发妊娠期肝内胆汁淤积症对产妇和胎儿脐动脉血生化指标以及围产儿预后的影响。方法将妊娠28周前发病的45例作为早发组，将妊娠28周及以后发病的163例作为晚发组，另选择同期健康单胎妊娠孕妇100例作为对照组。结果三组血清TBA、TBIL、DBIL、CG、ALT、AST 水平及病情严重程度差异显著（P＜0.05）。三组血清TBA、TBIL、DBIL、CG、ALT、AST差异显著（P＜0.05）。三组脐动脉血清TBA、NSE、cTnI、乳酸、pH值差异显著（P＜0.05）。母亲血清TBA与新生儿脐动脉血清TBA、NSE、cTnI呈正相关（P＜0.05）。早发组预后较晚发组更差（P＜0.05）。结论妊娠28周前发病娠期肝内胆汁淤积症病情更严重，对生化指标的影响更显著，经治疗后分娩前生化指标虽得到改善，但仍显著影响脐动脉胎儿损伤相关指标如NSE、cTnI、乳酸水平，早产率高，围产儿预后差。
目的：探討早髮妊娠期肝內膽汁淤積癥對產婦和胎兒臍動脈血生化指標以及圍產兒預後的影響。方法將妊娠28週前髮病的45例作為早髮組，將妊娠28週及以後髮病的163例作為晚髮組，另選擇同期健康單胎妊娠孕婦100例作為對照組。結果三組血清TBA、TBIL、DBIL、CG、ALT、AST 水平及病情嚴重程度差異顯著（P＜0.05）。三組血清TBA、TBIL、DBIL、CG、ALT、AST差異顯著（P＜0.05）。三組臍動脈血清TBA、NSE、cTnI、乳痠、pH值差異顯著（P＜0.05）。母親血清TBA與新生兒臍動脈血清TBA、NSE、cTnI呈正相關（P＜0.05）。早髮組預後較晚髮組更差（P＜0.05）。結論妊娠28週前髮病娠期肝內膽汁淤積癥病情更嚴重，對生化指標的影響更顯著，經治療後分娩前生化指標雖得到改善，但仍顯著影響臍動脈胎兒損傷相關指標如NSE、cTnI、乳痠水平，早產率高，圍產兒預後差。
목적：탐토조발임신기간내담즙어적증대산부화태인제동맥혈생화지표이급위산인예후적영향。방법장임신28주전발병적45례작위조발조，장임신28주급이후발병적163례작위만발조，령선택동기건강단태임신잉부100례작위대조조。결과삼조혈청TBA、TBIL、DBIL、CG、ALT、AST 수평급병정엄중정도차이현저（P＜0.05）。삼조혈청TBA、TBIL、DBIL、CG、ALT、AST차이현저（P＜0.05）。삼조제동맥혈청TBA、NSE、cTnI、유산、pH치차이현저（P＜0.05）。모친혈청TBA여신생인제동맥혈청TBA、NSE、cTnI정정상관（P＜0.05）。조발조예후교만발조경차（P＜0.05）。결론임신28주전발병신기간내담즙어적증병정경엄중，대생화지표적영향경현저，경치료후분면전생화지표수득도개선，단잉현저영향제동맥태인손상상관지표여NSE、cTnI、유산수평，조산솔고，위산인예후차。
Objective To investigate the impact of early onset of intrahepatic cholestasis of pregnancy on maternal and fetal umbilical artery blood biochemical parameters, and the effects of perinatal infant prognosis. Methods Pregnancy before 28 weeks 45 cases of the disease were acted as early-onset group, 163 cases of the disease after 28 weeks of pregnancy as late-onset group, 100 cases of single pregnancy health pregnant women were chose as control group. Results The serum TBA, TBIL, DBIL, CG, ALT, AST levels and the disease severity of three groups were statistically significant (P <0.05). The serum TBA, TBIL, DBIL, CG, ALT, AST of three groups were statistically significant (P <0.05). Umbilical artery serum TBA, NSE, cTnI, lactic acid, pH value of three groups were statistically significant (P <0.05). Maternal serum and neonatal serum TBA umbilical artery, NSE, cTnI were positively correlated(P <0.05). Early-onset group had worse prognosis late-onset group (P<0.05). Conclusion Pregnancy 28 weeks pregnant before the onset of intrahepatic cholestasis of more serious illness, the impact on biochemical indicators of more significant biochemical parameters before delivery after treatment, although improved, but still significantly affect fetal umbilical artery injury-related indicators such as NSE, cTnI, lactate levels, with higher premature birth rate, poorer prognosis of perinatal children.
