妊娠胆汁淤积症患者血清总胆汁酸、甘胆酸水平及其对新生儿肺损伤的影响

摘要

目的 检测妊娠胆汁淤积症患者血清总胆汁酸(TBA)、甘胆酸(CG)水平的变化并探讨其对新生儿肺损伤的影响.方法 选择2013年6月-2016年6月在西南医科大学附属中医医院新生儿科就诊的60例妊娠胆汁淤积症患者为观察组;另选择同期60例健康妊娠者为健康对照组.对2组孕妇的血清TBA、CG水平进行分析,并探讨其与新生儿肺损伤的相关性.结果 观察组患者的血清TBA、CG水平明显高于健康对照组,组间比较差异具有统计学意义(t =58.991、69.402,P＜0.01);观察组的新生儿肺损伤发生率明显高于健康对照组,组间比较差异具有统计学意义(40.0％ vs.11.7％,x2=12.570,P=0.000);观察组中,血清TBA水平＞30 μmo/L患者的新生儿肺损伤发生率明显高于水平≤30 μmol/L的患者,组间比较差异具有统计学意义(57.7％vs.26.5％,x2=5.984,P=0.014);血清CG水平＞40 μg/ml患者的新生儿肺损伤发生率明显高于水平≤40 μg/ml的患者,组间比较差异具有统计学意义(59.3％ vs.24.2％,x2=8.869,P=0.003).结论 妊娠胆汁淤积症患者血清TBA.、CG水平明显高于正常水平,同时新生儿肺损伤发生率也有所提高,二者之间可能有一定的相关性,具有重要的临床意义.%Objective To analyze the changes of total bile acid and cholyglycine in patients with intrahepatic cholestasis of pregnancy,and investigate their effects on neonatal lung injury.Methods Sxity cases of patients with intrahepatic cholestasis of pregnancy were selected,which were treated in hospital from June 2013 to June 2016,and recorded as observation group.Another 60 healthy pregnant women were selected as the control group.The levels of serum total bile acid (TBA) and cholyglycine (CG) in the two groups of pregnant women were analyzed and the correlation with the neonatal lung injury was analyzed.Results In the terms of serum TBA and CG,the patients of observation group were significantly higher than those of control group (t =58.991,t =69.402;P =0.000,P =0.000);The incidence of neonatal lung injury of observation group were significantly higher than those of control group (40.0％ vs.11.7％,x2 =12.570,P =0.000);In the observation group,the incidence of neonatal lung injury in patients with serum TBA levels higher than 30 μmol / L was significantly higher than that in patients with serum TBA levels below 30 μmol / L (57.7％ vs.26.5％,x2 =5.984,P =0.014);In the observation group,the incidence of neonatal lung injury in patients with serum CG levels higher than 40 μg / ml was significantly higher than that in patients with serum CG levels below 40 μg / ml (59.3％ vs.24.2％,x2 =8.869;P =0.003).Conclusion The serum TBA,CG levels of patients with intrahepatic cholestasis of pregnancy were significantly higher than the normal levels,and the incidence of neonatal lung injury has also increased,there may be a certain correlation between them,which makes it have an important clinical significance.