妊娠期肝内胆汁淤积症胆汁酸、肝酶指标对妊娠结局的影响

目的：探讨妊娠期肝内胆汁淤积症患者的胆汁酸、肝酶指标对患者妊娠结局的影响，为临床诊治妊娠期肝内胆汁淤积症患者给予参考。方法选择2012年1月～2013年10月我院收治的170例妊娠期肝内胆汁淤积症患者作为临床研究对象，对所有患者均给予胆汁酸、肝酶指标的检测，根据检测结果将患者分为轻度、中度和重度，并以同期我院收治的150例正常健康孕妇作为对照组，观察比较四组孕妇的妊娠结局。结果产后出血方面：重度妊娠期肝内胆汁淤积症患者的发生率最高，差异有统计学意义（P＜0.05）；重度妊娠期肝内胆汁淤积症患者剖宫产比例更高，新生儿窒息率更高，低体重儿比例高，新生儿Apgar评分低，与其他组别对比差异有统计学意义。结论对妊娠期肝内胆汁淤积症检测胆汁酸、肝酶指标，有助于判断患者的疾病严重程度，进而评估产妇和新生儿结局。

Influence of bile acids and liver enzyme indicators of gestational patients with intrahepatic cholestasis on pregnancy outcomes

Objective To analyze the influence of the bile acids and liver enzyme indicators of gestational patients with intrahepatic cholestasis on the pregnancy outcomes and provide reference for the clinical diagnosis and treatment of gestational patients with intrahepatic cholestasis. Methods 170 gestational patients with intrahepatic cholestasis treated in our hospital from January 2012 to October 2013 were selected as the clinical study subjects and all the patients were given bile acids and liver enzyme indicators detection. The patients were divided into the mild, moderate and severe groups according to the detection results and 150 normal healthy pregnant women admitted to our hospital in the same period were selected as the control group. The pregnancy outcomes of the four groups of pregnant women were observed. Results Regarding to postpartum bleeding, the gestational patients with severe intrahepatic cholestasis had the highest incidence, with statistically significant difference（P 〈 0.05）. The gestational patients with severe intrahepatic cholestasis had higher proportion of cesarean section, higher neonatal asphyxia rate, higher proportion of low birth weight infants and lower neonatal Apgar score, with statistically significant differences to the other groups. Conclusion The detection of bile acids and liver enzyme indicators of the gestational patients with intrahepatic cholestasis is conducive to determining the severity of illness and thus evaluating maternal and neonatal outcomes.