【摘要】 目的探讨肝内胆汁淤积症 (ICP)孕妇血清总胆汁酸 (TBA)水平与围产儿预后的关系。方法对 135例ICP孕妇TBA值及围产儿预后进行回顾性分析。结果孕妇血清TBA值越高 ,皮肤瘙痒出现时间越早 ;血清TBA值显著升高者 ,其反映肝功能指标的总胆红素 (TBI)值也相应升高 ,而谷丙转氨酶 (SGPT)值升高不显著 ;血清TBA值显著升高者 ,胎儿窘迫发生率显著增加 ,早产、围产儿死亡及小于孕龄儿发生率均显著增加。结论ICP孕妇血清TBA值显著升高者围产儿预后不佳 ,测定血清TBA值是早期诊断ICP的最佳方法 ,能真实地反映和预测其发生妊娠不良结局的可能性。适时剖宫产终止妊娠将明显改善ICP孕妇围产儿预后。更多还原

【Abstract】 ObjectivesTo investigate the relationship between maternal serum levels of total bile acid (TBA) and prognosis of perinatal fetus in pregnant women with intrahepatic cholestasis (IC).MethodsThe serum TBA levels and prognosis of perinatal fetus in one hundred and thirty five pregnant women with IC were studied retrospectively.ResultsThe increased serum TBA level was closely related to the early occurrence of maternal skin pruritus and revealed also a positive correlation with serum level of total bilirubin (TBI). But it was not concerned in serum activity of glutamate pyruvate transaminase(SGPT). When the serum TBA levels elevated, the incidences of meconium passage and fetal distress would be increased, accompanying with increased premature delivery and fetal death rate.ConclusionThe fetal prognosis in pregnant women with high serum TBA levels is bad; The estimation of serum TBA level serves as the best measure for early diagnosis of IC , for it will truly reflect and predict the bad outcome of pregnancy. The prognosis of fetus can be improved by cesarean section at proper time. [更多还原