血清甘胆酸水平与妊娠期肝内胆汁淤积症患者不良妊娠结局的相关性

摘要/Abstract

摘要： 目的探讨血清甘胆酸水平与妊娠期肝内胆汁淤积症(ICP)患者不良妊娠结局的相关性,以指导未来ICP患者早期干预,促进良性妊娠结局。方法选取2017年5月至2020年4月邳州市人民医院的260例ICP患者作为研究对象,统计患者的妊娠结局并据此分为不良妊娠结局组和对照组,检测两组血清甘胆酸水平,分析血清甘胆酸水平对ICP患者不良妊娠结局的影响与预测价值。结果本研究260例ICP患者中,83例妊娠结局不良,不良妊娠结局发生率为31.92%;不良妊娠结局组血清甘胆酸水平高于对照组,差异有统计学意义(P<0.05),组间其他基线资料比较差异无统计学意义(P＞0.05);经单项Logistic回归分析并建立多元回归模型行多因素分析结果显示,血清甘胆酸水平高表达是ICP患者不良妊娠结局的影响因素(OR＞1,P<0.05);绘制ROC曲线发现,血清甘胆酸水平检测用于ICP患者不良妊娠结局预测的AUC为0.868,有一定预测价值,且当血清肝胆酸的截断值取2.670 μmol/L时,可以获得最佳的预测价值。结论 ICP患者有不良妊娠结局高风险,血清甘胆酸水平过表达可能参与了ICP患者不良妊娠结局的发生,早期检测血清甘胆酸水平可预测妊娠结局,可能对指导早期干预方案拟定和改善妊娠结局具有积极意义。

关键词: 妊娠期肝内胆汁淤积症, 不良妊娠结局, 甘胆酸, 总胆汁酸

Abstract: Objective To investigate the correlation between the level of serum glycocholic acid and adverse pregnancy outcomes in patients with intrahepatic cholestasis (ICP) during pregnancy, so as to guide early intervention in future ICP patients and promote benign pregnancy outcomes.Methods From May 2017 to April 2020, 260 patients with ICP in the hospital were selected as the research objects. The pregnancy outcomes of the patients were counted and divided into a poor pregnancy outcome group and a control group. The serum levels of glycocholic acid in the two groups were detected and the influence and predictive value of serum glycocholic acid levels on adverse pregnancy outcomes in ICP patients were analyzed.Results Among the 260 ICP patients in this study, eighty-three patients had poor pregnancy outcomes, and the incidence of adverse pregnancy outcomes was 31.92%; the serum glycocholic acid level in the adverse pregnancy outcome group was higher than that of the control group, and the difference was statistically significant (P<0.05); compared other baseline data between groups, the difference was not statistically significant (P>0.05); after single logistic regression analysis and establishment of multiple regression model, the results of multivariate analysis showed that the high expression of serum glycocholic acid was the influencing factor of the adverse pregnancy outcome of ICP patients (OR>1, P<0.05); the ROC curve was drawn and found that the AUC of serum glycocholic acid levels used to predict adverse pregnancy outcomes in ICP patients was 0.868, which had certain predictive value. And when the cut-off of serum hepatic acid was 2.670μmol/L, the best predictive value could be obtained.Conclusion Patients with ICP are at high risk of adverse pregnancy outcomes. Overexpression of serum glycocholic acid level may be involved in the occurrence of adverse pregnancy outcomes in ICP patients. Early detection of serum glycocholic acid levels can predict pregnancy outcomes, and may be of positive significance for guiding the formulation of early intervention programs and improving pregnancy outcomes.

Key words: Intrahepatic cholestasis of pregnancy, Adverse pregnancy outcome, Glycocholic acid, Total bile acid

薛魁, 石慧, 王文娟. 血清甘胆酸水平与妊娠期肝内胆汁淤积症患者不良妊娠结局的相关性[J]. 肝脏, 2021, 26(8): 920-923.

XUE Kui, SHI Hui, WANG Wen-juan. Correlation between serum glycocholic acid levels and adverse pregnancy outcomes in patients with intrahepatic cholestasis of pregnancy[J]. Chinese Hepatolgy, 2021, 26(8): 920-923.

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