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目的探讨妊娠合并肝内胆汁淤积症（ＩＣＰ）胎儿宫内缺氧的预测指标。方法对１０７例ＩＣＰ患者多项临床及实验室指标进行观察，并将其与围产儿结局进行对照分析。结果皮肤瘙痒持续时间≥３周、血清转氨酶和胆红素同时升高、ＮＳＴ胎心基线率变异消失者羊水胎粪污染率、新生儿窒息率及围产儿病死率，分别高于皮肤瘙痒持续时间＜３周（Ｐ＜００１）、单纯转氨酶升高而胆红素值正常（Ｐ＜００１）、ＮＳＴ胎心基线率变异正常者（Ｐ＜００１）。血清甘胆酸升高的程度与羊水胎粪污染和新生儿Ａｐｇａｒ评分无关。结论皮肤瘙痒持续时间≥３周、血清转氨酶和胆红素同时升高、ＮＳＴ胎心基线率变异消失可作为预测ＩＣＰ胎儿宫内缺氧的指标。
Objective To investigate the predictive value of intrauterine hypoxia in pregnancy with intrahepatic cholestasis (ICP). Methods The clinical and laboratory indexes of 107 patients with ICP were observed and compared with those of perinatal children. Results Pruritus duration ≥3 weeks, serum aminotransferase and bilirubin increased at the same time. The rate of meconium-stained amniotic fluid, neonatal asphyxia and perinatal mortality were higher than that of pruritus <3 weeks (P <001), simple aminotransferase and bilirubin values were normal (P <001), NST fetal heart rate baseline normal variation (P <001). The degree of elevated serum glycocholate has nothing to do with amniotic fluid meconium contamination and neonatal Apgar score. Conclusion Pruritus duration ≥3 weeks, both serum aminotransferase and bilirubin increased at the same time. The disappearance of baseline rate variability of fetal heart rate in NST could be used as an index to predict fetal intrauterine hypoxia.