论文部分内容阅读
目的探讨临床症状和生化指标对妊娠期肝内胆汁淤积症患者(ICP)的早产预测价值。方法观察60例已确诊为ICP的患者,将妊娠不满37足周分娩的早产患者通过Logistic回归分析统计结果,并计算其优势比(OR,95%置信区间)。结果60例ICP患者平均孕期为(38.1±1.7)周,无死胎现象。早产8例(13.3%),与孕足月妊娠ICP患者相比,早产ICP患者的血清胆汁酸更高[(47.8±15.2)μmol/Lvs(41.0±10.0)μmol/L,P<0.05],出现全身瘙痒症状的时间更早[(29.0±3.9)周vs(31.6±3.3)周,P=0.057]。Logistic回归分析显示,全身瘙痒症状的首次出现时间(OR 1.7,95%CI1.23~2.95,P=0.038)和血清胆汁酸(OR 2.13,95%CI 1.13~2.25,P=0.013)是两个早产的独立预测因子。结论在ICP患者中,孕妇瘙痒症状的首发时间及血清胆汁酸浓度是对早产的两个较好的预测指标。
Objective To investigate the predictive value of clinical symptoms and biochemical parameters in preterm labor of intrahepatic cholestasis of pregnancy (ICP). Methods Sixty patients diagnosed with ICP were enrolled in this study. Logistic regression analysis was used to analyze the prevalence of preterm birth in 37-week pregnant women who delivered less than 37 weeks of pregnancy. The odds ratio (OR, 95% confidence interval) was calculated. Results The average pregnancy of 60 patients with ICP was (38.1 ± 1.7) weeks without any stillbirth. There were 8 cases of preterm labor (13.3%), and serum bile acid was higher in preterm labor ICP patients (47.8 ± 15.2 μmol / L vs 41.0 ± 10.0 μmol / L, P <0.05) Symptoms of systemic pruritus occurred earlier (29.0 ± 3.9 weeks vs 31.6 ± 3.3 weeks, P = 0.057). Logistic regression analysis showed that the first onset of systemic itching (OR 1.7, 95% CI 1.23-2.95, P = 0.038) and serum bile acid (OR 2.13, 95% CI 1.13-2.25, P = 0.013) were two Independent predictors of preterm birth. Conclusions The first episode of pruritus in pregnant women and serum bile acid concentrations are two good predictor of preterm birth in ICP patients.