袁弘玉,Hongyu Yuan,黄静宜,Jingyi Huang,鲜光虹,Guanghong Xian,李 英,Ying Li,刘明伟,Mingwei Liu,赵福英,Zhao Fuying

目的：针对妊娠期肝内胆汁淤积症孕妇患者与围生儿预后之间的关系。方法：收取妊娠期肝内胆汁淤积症孕妇为观察组，再选取正常孕妇为对照组，收集2019年5月-2021年1月产科收治ICP待产孕妇，取同期正常孕妇为对比组，比较两组孕妇肝功能及血清、脐血及羊水三个不同部位胆汁酸的水平。结果：观察组新生儿死亡4.27%、早产16.78%、新生儿窒息16.02%、胎儿窘迫发生率32.77%，高于对照组（P＜0.05）；观察组妊娠期肝内胆汁淤积症孕妇TBA水平（32.39±17.60）μmol/L，高于对照组孕妇（P＜0.05）；观察组妊娠期肝内胆汁淤积症产后出血量（411.23±10.25）ml，高于对照组；观察组妊娠期肝内胆汁淤积症胎儿体质量（2.06±0.19）kg、妊娠期肝内胆汁淤积症Apger评分（6.33±1.16）低于对照组（P＜0.05）。结论：妊娠期肝内胆汁淤积症孕妇TBA水平与围生儿预后密切相关。 Objective: To investigate the relationship between intrahepatic cholestasis of pregnancy and perinatal prognosis.Methods: Pregnant women with intrahepatic cholestasis of pregnancy were selected as the observation group, and normal pregnant women were selected as the control group. ICP pregnant women who were admitted to obstetrics department from May 2019 to January 2021 were collected, and normal pregnant women in the same period were selected as the control group. The levels of liver function and bile acid in serum, cord blood and amniotic fluid of the two groups were compared.Results: The incidence of neonatal death, premature delivery, asphyxia and fetal distress in the observation group was 4.27%,16.78%,16.02% and 32.77%, respectively, which was higher than that in the control group (P <0.05).The fetal body weight (2.06±0.19) kg and Apger score (6.33±1.16) of intrahepatic cholestasis of pregnancy in the observation group were lower than those in the control group (P <0.05).Conclusion: The level of TBA in pregnant women with intrahepatic cholestasis of pregnancy is closely related to the prognosis of perinatal infants.

妊娠期肝内胆汁淤积症孕妇；血清甘胆酸；血清总胆汁酸；围生儿预后 Intrahepatic cholestasis of pregnancy; serum glycocholic acid; serum total bile acid; perinatal prognosis

[1] 牛力春,张颖,李世梅,等.妊娠期肝内胆汁淤积症 30 例胎儿不良结局原因分析[J].陕西医学杂志,2012,41:1621-1624. [2] 刘建国,徐珊珊,蒋玉,等.妊娠期肝内胆汁淤积症孕妇 CG、TBA 水平与围生儿预后关系研究[J].湖南师范大学学报(医学版),2014,11:76 [3] 周洋.47 例妊娠期肝内胆汁淤积症临床分析[J].中国血液流变学杂志,2018,28(2):191-192,218.

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