妊娠肝内胆汁淤积症孕妇胎儿呼吸窘迫影响因素研究

摘要

Objective To explore influence factors of fetal asphyxia in pregnant women with intrahepatic cholestasis of pregnan‐cy (ICP) .Methods Three hundreds thirty‐six pregnant women with ICP were collected from January 2012 to March 2015 in Chengdu women′s and children′s central hospital .According to whether fetal asphyxia occurred or not ,the women were divided to the observation group and the control group .Pathogenic week of gestation and biochemical indicators were analyzed and compared between the two groups .Results The differences of the levels of alanine transaminase (ALT) ,aspartate aminotransferase (AST) , total bile acids (TBA) ,glycocholic acid (CG) and pathogenic week of gestation between the two groups had statistical significances (P<0 .05) .Logistic regression analysis demonstrated that TBA ,CG levels and the pathogenic week of gestation were the most im‐portant indicators in predicting fetal asphyxia in pregnant women with ICP .Conclusion The increase of TBA and CG levels as well as exposure time in serum concentration of bile acids in pregnant women with ICP may lead to increase the risk of asphyxia in new‐bo rns .%目的：研究妊娠肝内胆汁淤积症（IC P ）患者胎儿呼吸窘迫的影响因素。方法收集2012年1月至2015年3月成都市妇女儿童中心医院IC P患者336例，按照胎儿窘迫的发生情况分为观察组和对照组，分析两组间首次诊断为IC P时生化指标及妊娠结局的差异，并探索ICP患者发生胎儿窘迫的影响因素。结果发病时间、丙氨酸氨基转移酶（ALT ）、天冬氨酸氨基转移酶（AST）、总胆汁酸（TBA）以及甘胆酸（CG）在观察组和对照组间的差异均存在统计学意义（P＜0．05）。多元Logistic回归分析发现，发病时间、TBA、CG是ICP患者发生胎儿窘迫的影响因素。结论随着母体中 TBA及CG的升高及在高胆汁酸环境中暴露时间越长更有可能增加引起IC P患者发生胎儿窘迫的风险。