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In Search of an Accurate Evaluation of Intrahepatic Cholestasis of Pregnancy

机译:为了准确评估妊娠肝内胆汁淤积症

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摘要

Until now, biochemical parameter for diagnosis of intrahepatic cholestasis of pregnancy (ICP) mostly used is the rise of total serum bile acids (TSBA) above the upper normal limit of 11 μM. However, differential diagnosis is very difficult since overlapped values calculated on bile acids determinations, are observed in different conditions of pregnancy including the benign condition of pruritus gravidarum. The aim of this work was to determine the better markers in ICP for a precise diagnosis together with parameters associated with severity of symptoms and treatment evaluation. Serum bile acid profiles were evaluated using capillary electrophoresis in 38 healthy pregnant women and 32 ICP patients and it was calculated the sensitivity, specificity, accuracy, predictive values and the relationships of certain individual bile acids in pregnant women in order to replace TSBA determinations. The evaluation of the results shows that LCA and UDCA/LCA ratio provided information for a more complete and accurate diagnosis and evaluation of ICP than calculation of solely TSBA levels in pregnant women.
机译:迄今为止,诊断肝内胆汁淤积症(ICP)的主要生化参数是血清总胆汁酸(TSBA)升高超过正常上限11μm。但是,由于在不同的妊娠状况(包括妊娠瘙痒的良性状况)中观察到根据胆汁酸测定值计算出的重叠值,因此鉴别诊断非常困难。这项工作的目的是确定ICP中更好的标记物,以进行准确的诊断以及与症状严重程度和治疗评估相关的参数。使用毛细管电泳对38例健康孕妇和32例ICP患者的血清胆汁酸谱进行了评估,并计算了孕妇中某些胆汁酸的敏感性,特异性,准确性,预测值和关系,以代替TSBA的测定。结果评估表明,与仅计算孕妇的TSBA水平相比,LCA和UDCA / LCA比值为ICP的诊断和评估提供了更为完整和准确的信息。

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