中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2014年
11期
1281-1283
,共3页
妊娠%肝内胆汁淤积症,妊娠期%围产儿%预后
妊娠%肝內膽汁淤積癥,妊娠期%圍產兒%預後
임신%간내담즙어적증,임신기%위산인%예후
Pregnancy%Intrahepatic cholestasis of pregnancy%Perinatal%Prognosis
目的 探讨妊娠期肝内胆汁淤积症产前监测指标与围产儿预后相关性.方法 采用病例对照方法回顾性分析2011年1月至2014年1月同济医学院附属普爱医院收治的88例妊娠期肝内胆汁淤积症患者及其围产儿(研究组)的临床资料,选取同期收治的正常妊娠妇女100例及其围产儿为对照组,分析妊娠期肝内胆汁淤积症产前监测指标与围产儿预后的关系及其围产儿流行病学特点.结果 研究组围产儿羊水粪源性感染、新生儿窒息、早产儿和胎儿宫内窘迫发生率均明显高于对照组,差异有统计学意义(P＜0.05).研究组中围产儿不良组孕妇甘胆酸(CG)、ALT、AST、总胆红素(TBIL)、直接胆红素(DBIL)和总胆汁酸(TBA)水平均明显比良好组孕妇高,差异有统计学意义(P＜0.05).多因素回归分析显示,CG、ALT、AST、TBIL和TBA与围产儿预后不良有明显关系.围产儿疾病中以羊水粪源性感染为最多(33.3％),其次为早产儿(28.6％)、胎儿宫内窘迫(20.6％)、新生儿窒息(15.9％)和死胎(1.6％).结论 妊娠期肝内胆汁淤积症孕妇围产儿预后不良发生率较高,其中以羊水粪源性感染为最多,产前CG、ALT、AST、TBIL和TBA水平监测可作为预测围产儿预后的指标.
目的 探討妊娠期肝內膽汁淤積癥產前鑑測指標與圍產兒預後相關性.方法 採用病例對照方法迴顧性分析2011年1月至2014年1月同濟醫學院附屬普愛醫院收治的88例妊娠期肝內膽汁淤積癥患者及其圍產兒(研究組)的臨床資料,選取同期收治的正常妊娠婦女100例及其圍產兒為對照組,分析妊娠期肝內膽汁淤積癥產前鑑測指標與圍產兒預後的關繫及其圍產兒流行病學特點.結果 研究組圍產兒羊水糞源性感染、新生兒窒息、早產兒和胎兒宮內窘迫髮生率均明顯高于對照組,差異有統計學意義(P＜0.05).研究組中圍產兒不良組孕婦甘膽痠(CG)、ALT、AST、總膽紅素(TBIL)、直接膽紅素(DBIL)和總膽汁痠(TBA)水平均明顯比良好組孕婦高,差異有統計學意義(P＜0.05).多因素迴歸分析顯示,CG、ALT、AST、TBIL和TBA與圍產兒預後不良有明顯關繫.圍產兒疾病中以羊水糞源性感染為最多(33.3％),其次為早產兒(28.6％)、胎兒宮內窘迫(20.6％)、新生兒窒息(15.9％)和死胎(1.6％).結論 妊娠期肝內膽汁淤積癥孕婦圍產兒預後不良髮生率較高,其中以羊水糞源性感染為最多,產前CG、ALT、AST、TBIL和TBA水平鑑測可作為預測圍產兒預後的指標.
목적 탐토임신기간내담즙어적증산전감측지표여위산인예후상관성.방법 채용병례대조방법회고성분석2011년1월지2014년1월동제의학원부속보애의원수치적88례임신기간내담즙어적증환자급기위산인(연구조)적림상자료,선취동기수치적정상임신부녀100례급기위산인위대조조,분석임신기간내담즙어적증산전감측지표여위산인예후적관계급기위산인류행병학특점.결과 연구조위산인양수분원성감염、신생인질식、조산인화태인궁내군박발생솔균명현고우대조조,차이유통계학의의(P＜0.05).연구조중위산인불량조잉부감담산(CG)、ALT、AST、총담홍소(TBIL)、직접담홍소(DBIL)화총담즙산(TBA)수평균명현비량호조잉부고,차이유통계학의의(P＜0.05).다인소회귀분석현시,CG、ALT、AST、TBIL화TBA여위산인예후불량유명현관계.위산인질병중이양수분원성감염위최다(33.3％),기차위조산인(28.6％)、태인궁내군박(20.6％)、신생인질식(15.9％)화사태(1.6％).결론 임신기간내담즙어적증잉부위산인예후불량발생솔교고,기중이양수분원성감염위최다,산전CG、ALT、AST、TBIL화TBA수평감측가작위예측위산인예후적지표.
Objective To investigate the association between prenatal monitoring index in intrahepatic cholestasis of pregnancy and the perinatal prognosis,as well as the characteristics of perinatal situations.Methods A retrospective study on the clinical data of 88 cases intrahepatic cholestasis of pregnancy and prognosis that were treated in our hospital from Jan.2011 to Jan.2014 was carried out.Relationship between prenatal monitoring index in intrahepatic cholestasis of pregnancy and perinatal prognosis,together with the epidemiological features of infants were analyzed.Results The incidence rates of perinatal meconium stained amniotic fluid,asphyxia neonatorum,premature and fetal distress were significantly higher in the study group than those in the controls,with differences statistically significant (P＜0.05).The levels of CG,ALT,AST,TBIL,DBIL and TBA in puerperant with bad perinatal situation were significantly higher than puerperant with good perinatal situation,with the difference statistically significant (P＜0.05).Results from the multiple regression analysis indicated that close relations did exist between CG,ALT,AST,TBIL,TBA and adverse perinatal prognosis.The main perinatal risks were related to meconium stained amniotic fluid (33.3％),prematurity (28.6％),fetal distress (20.6％),asphyxia neonatorum (15.9％) and stillbirth (1.6％).Conclusion The rate of adverse perinatal prognosis was low in intrahepatic cholestasis of pregnancy,with most frequently seen as meconium stained amniotic fluid.It was necessary to monitor the level of prenatal CG,ALT,AST,TBIL and TBA in puerperant in predicting the perinatal prognosis.
