血清phIGFBP-1水平对妊娠期肝内胆汁淤积症孕妇及胎儿的影响

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摘要目的探讨血清磷酸化胰岛素样生长因子结合蛋白-1（phIGFBP-1）水平对妊娠期肝内胆汁淤积症（ICP）孕妇及胎儿的影响。方法回顾性分析2019年3月—2020年1月江苏省淮安市妇幼保健院（以下简称“我院”）ICP患者42例为实验组；同期我院正常妊娠孕妇42例为对照组。比较两组血清总胆汁酸（TBA）、天门冬氨酸氨基转移酶（AST）和丙氨酸氨基转移酶（ALT）及血清phIGFBP-1水平。根据血清phIGFBP-1水平，将实验组分为20~35 ng/mL组及＞35 ng/mL组，比较不同血清phIGFBP-1水平早产、产后出血、1 min Apgar评分、胎儿窘迫、新生儿窒息发生情况。观察血清phIGFBP-1水平与TBA、AST、ALT、胎心率、胎儿脐动脉的阻力指数(RI)、搏动指数(PI)、脐静脉导管分流率的相关性。结果实验组TBA、AST、ALT、phIGFBP-1水平及胎心率、RI、PI和脐静脉导管分流率高于对照组（均P < 0.05）。＞35 ng/mL组早产、胎儿窘迫、新生儿窒息发生率高于20~35 ng/mL组，而1 min Apgar评分低于20~35 ng/mL组（均P ＜ 0.05）。血清phIGFBP-1水平与胎心率、RI、PI、脐静脉导管分流率呈正相关（P < 0.05）。结论血清phIGFBP-1水平能为ICP孕妇提供病情预后评估，并为胎儿宫内窘迫提供诊断参考。

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	姜素娥1 张曙萱2 郑晓晓3▲

关键词 ：妊娠期肝内胆汁淤积症, 总胆汁酸, 磷酸化胰岛素样生长因子结合蛋白-1, 预后

Abstract：Objective To investigate the effect of serum phosphorylated sulin-like growth factor binding protein-1 (phIGFBP-1) levels on pregnant women and fetuses with intrahepatic cholestasis of pregnancy (ICP). Methods Retrospective analysis was conducted on 42 cases with ICP patients in Huai’an Maternal and Child Health Care Hospital of Jiangsu Province (hereinafter referred to as “our hospital”) from March 2019 to January 2020 as the experimental group. During the same period, 42 cases of normal pregnant women in our hospital were the control group. The levels of total bile acid (TBA), aspartate amino transferase (AST), alanine aminotransferase (ALT) and serum phIGFBP-1 were compared between the two groups. According to the serum phIGFBP-1 level, the experimental group was divided into 20-35 ng/mL group and >35 ng/mL group. The incidence of premature birth, postpartum hemorrhage, 1 min Apgar score, fetal distress and neonatal asphyxia were compared among different serum levels of phIGFBP-1. The correlation between serum phIGFBP-1 level and TBA, AST, ALT, fetal heart rate, fetal umbilical artery resistive index (RI), pulsatility index (PI), and umbilical venous ductus shunt rate were observed. Results TBA, AST, ALT, phIGFBP-1 levels and fetal heart rate, RI, PI and umbilical venous ductus shunt rate in the experimental group were higher than those in the control group (all P < 0.05). The incidence of premature birth, fetal distress and neonatal asphyxia in > 35 ng/mL group were higher than those in 20-35 ng/mL group, while 1 min Apgar score was lower than 20-35 ng/mL group (P < 0.05) . The serum phIGFBP-1 level was positively correlated with fetal heart rate, RI, PI, and umbilical venous ductus shunt rate (P < 0.05). Conclusion Serum phIGFBP-1 level can provide prognosis evaluation for ICP pregnant women, and provide diagnostic reference for fetal distress.

Key words： Intrahepatic cholestasis of pregnancy Total bile acid Phosphorylated insulin-like growth factor binding protein-1 Prognosis

基金资助:江苏省妇幼健康科研项目（F201731）。

通讯作者: ▲通讯作者

引用本文:

姜素娥1 张曙萱2 郑晓晓3▲. 血清phIGFBP-1水平对妊娠期肝内胆汁淤积症孕妇及胎儿的影响[J]. 中国医药导报, 2021, 18(12): 119-122.
JIANG Su’e1 ZHANG Shuxuan2 ZHENG Xiaoxiao3▲. Effect of serum phIGFBP-1 levels on pregnant women and fetuses with intrahepatic cholestasis of pregnancy. 中国医药导报, 2021, 18(12): 119-122.

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https://www.yiyaodaobao.com.cn/CN/ 或 https://www.yiyaodaobao.com.cn/CN/Y2021/V18/I12/119

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