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目的:探讨脂质过氧化作用与ICP围产儿预后的关系。方法:分别用硫代巴比妥酸荧光测定法和邻苯三酚自氧法测定同期正常晚期妊娠妇女102例(对照组)及妊娠期肝内胆汁瘀积症(ICP)患者126例(观察组)的血浆和脐静脉血脂质过氧化物(LPO)和红细胞超氧化物歧化酶(RBC-SOD)活性;比较新生儿出生体重、Apgar评分和羊水状况。结果:ICP组宫内发育迟缓(IUGR)、羊水异常和新生儿窒息率均明显高于对照组(P<001)。ICP组母儿血LPO浓度均明显高于对照组(P<001);母血RBC-SOD活性明显高于对照组(P<001),脐血RBC-SOD活性与对照组无显著性差异(P>005)。在ICP组,IUGR、新生儿窒息和羊水异常时,脐血LPO浓度均明显增高,而脐血RBC-SOD活性均明显下降。ICP组脐血LPO与新生儿出生体重和Apgar评分呈明显负相关(r=-0584,P<001;r=-0475,P<005)。结论:脂质过氧化作用与ICP的IUGR、新生儿窒息和胎儿宫窘迫等围产儿不良预后密切相关。
Objective: To investigate the relationship between lipid peroxidation and perinatal outcome in ICP. Methods: 102 cases of normal late pregnant women (control group) and 126 cases of intrahepatic cholestasis of pregnancy (ICP) during pregnancy were measured by thiobarbituric acid fluorescence assay and pyrogallol autoxidation method respectively (LPO) and erythrocyte superoxide dismutase (RBC-SOD) in the plasma and umbilical vein. The neonatal birth weight, Apgar score and amniotic fluid status were compared. Results: Intrauterine growth retardation (IUGR), amniotic fluid abnormality and neonatal asphyxia in ICP group were significantly higher than those in control group (P <001). The level of LPO in maternal blood of ICP group was significantly higher than that of control group (P <001). The activity of RBC-SOD in maternal blood was significantly higher than that of control group (P <001). The activity of RBC-SOD in cord blood was not significantly different from that of control group P> 005). In the ICP group, IUGR, neonatal asphyxia and amniotic fluid abnormalities, cord blood LPO concentrations were significantly increased, while cord blood RBC-SOD activity were significantly decreased. LPO in umbilical cord blood of ICP group was negatively correlated with neonatal birth weight and Apgar score (r = -0584, P <001; r = -0475, P <005). CONCLUSIONS: Lipid peroxidation is closely related to the poor prognosis of perinatal children such as ICP IUGR, neonatal asphyxia and fetal distress.