Clinical analysis of 98 patients with intrahepatic cholestasis of pregnancy in the Buyi nationality of Guizhou
YANG Xiulian1 LI Jin2#br#
1.Department of Obstetrics and Gynecology,the Third People′s Hospital of Huizhou,Guangdong Province,Huizhou 516000,China;
2.Department of Obstetrics and Gynecology,the People′s Hospital of Ceheng County,Guizhou Province,Ceheng 552200,China
Objective To analyze the clinical data of 98 cases of pregnant women with intrahepatic cholestasis(ICP)of Buyi nationality in Guizhou province,and to explore the clinical characteristics of ICP.Methods The clinical data of 98 buyi pregnant women with ICP who delivered in the Department of Obstetrics and Gynecology of the People′s Hospital of Ceheng County from January 2018 to January 2022 were selected as the case group.According to the severity of the disease,the case group was divided into mild group(67 cases)and severe group(31 cases).According to the presence or absence of skin pruritus,the patient group was divided into itch group(50 cases)and non-itch group(48 cases).Another 110 healthy pregnant women of Buyi nationality who gave birth in this hospital were selected as the control group,and the skin pruritus,liver function and adverse pregnancy outcome among the groups were analyzed.Results The incidence of pruritus,alanine aminotransferase(ALT)and aspartate aminotransferase(AST)levels,amniotic fluid contamination,fetal growth restriction,fetal distress,premature delivery and neonatal asphyxia in case group were higher than those in control group,and the differences were statistically significant(P<0.05).The incidence of pruritus,ALT and AST levels,amniotic fluid contamination,fetal distress,fetal growth restriction,premature delivery,neonatal asphyxia and perinatal death in severe group were higher than those in mild group,and the differences were statistically significant(P<0.05).The levels of total bile acid(TBA),ALT and AST in pruritus group were higher than those in non-pruritus group,with statistical significances(P<0.05).Conclusion Strengthening the awareness of pregnancy health care,advocating healthy diet,paying attention to pruritus symptoms and potential hazards during pregnancy,early diagnosis,active treatment,close monitoring,and choosing the best delivery time and way are the keys to reduce the adverse pregnancy outcome of local ICP.
杨秀莲;李津. 98例贵州布依族妊娠期肝内胆汁淤积症患者临床分析[J]. 中国当代医药, 2022, 29(29): 24-28.
YANG Xiulian1 LI Jin2. Clinical analysis of 98 patients with intrahepatic cholestasis of pregnancy in the Buyi nationality of Guizhou. 中国当代医药, 2022, 29(29): 24-28.
Chen J,Deng W,Wang J.Primary bile acids as potential biomarkers for the clinical grading of intrahepatic cholestasis of pregnancy[J].Int J Gynaecol Obstet,2013,122(1):5-8.
Brouwers L,Koster MP,Page-Christiaens GC,et al.Intrahepatic c holestasis of pregnancy:maternal and fetal outcomes associated with elevated bile acid levels[J].Am J Obstet Gynaecol,2015,212(1):100-107.
[12]
Smith DD,Rood KM.Intrahepatic cholestasis of pregnancy[J].Clin Obstet Gynecol,2020,63(1):134-151.
Pu J,Yuan A,Shan P.Cardiomyocyte-expressed farnesoid-X-receptor is a novel apoptosis mediator and contributes to myocardial is chaemia/reperfusion injury[J].Eur Heart J,2013,34(24):1834-1845.
Kirbas O,Biberoglu EH,Kirbas A.Evaluation of ventricular repolarization in pregnant women with intrahepatic cholestasis[J].Int J Cardiol,2015,189:25-29.
Martinez-Medina M,Denizot J,Dreux N,et al.Westerndiet induces dysbiosis with increased E coli in CEABAC10 mice,alters host barrier function favouring AIEC colonisation[J].Gut,2014,63(1):116-124.
Yoshimoto S,Loo TM,Atarashi K,et al.Obesity-induced gut micrlbial metabolite promotes liver cancer through senescence secretome[J].Nature,2013,499(7456):97-101.