OBJECTIVE: To investigate the changes of serum bile acid chromatograms before and after ursodeoxycholic acid (UDCA) in the treatment of intrahepatic cholestasis of pregnancy (ICP). METHODS: Seven types of serum bile acids were detected by HPLC-MS/MS in the ICP before and 4 weeks after UDCA treatment. RESULTS: After UDCA treatment, serum ALT, AST, TBIL and DBIL levels of the patients with ICP were significantly decreased (i><0.05). The serum levels of cholic acid (CA), gly-cocholic acid (GCA), taurocholic acid (TCA), taurolithocholic acid (TLCA) and lithocholic acid (LCA) in the ICP group before treatment were significantly higher than in control group(P<0.05). The serum levels of CA, GCA, TLCA and TCA in the ICP group after treatment decreased significantly while the content of UDCA were increased significantly, there was significant difference (P<0.05 or P<0.01). CONCLUSION: The serum bile acids profiles of intrahepatic cholestasis of pregnancy decrease after UDCA treatment, especially CA, GCA, TCA and TLCA.%目的:探讨熊去氧胆酸(UDCA)对妊娠期肝内胆汁淤积症(ICP)孕妇血清胆汁酸谱的影响.方法:采用高效液相色谱串联质谱(HPLC-MS/MS)法检测ICP患者(孕期26～32周)接受UDCA治疗前及治疗后4周血清中7种胆汁酸的变化.结果:UDCA治疗ICP患者后与治疗前比较,血清肝功能指标丙氨酸氨基转移酶(ALT)、天门冬酸氨基转移酶(AST)、总胆红素(TBIL)、直接胆红素(DBIL)显著下降(P＜0.05);ICP患者治疗前血清胆汁酸谱中,胆酸(CA)、甘氨胆酸(GCA)、牛磺胆酸(TCA)、牛磺石胆酸(TLCA)和石胆酸(LCA)水平均显著高于正常对照组(P＜0.05);ICP患者治疗后与治疗前血清胆汁酸谱比较,UDCA显著升高,CA、GCA、TLCA和TCA显著下降,差异均具有统计学意义(P＜0.05或P＜0.01).结论:UDCA能显著地降低ICP患者的高胆汁酸水平,其中CA、GCA、TCA、TLCA水平下降最为明显.
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