Diagnosis application value of serum glycocholic acid, total bile acid, alanine transarninase and thyroid stimulating hormone levels′ detection in intrahepatic cholestasis of pregnancy

doi:10.3877/cma.j.issn.1673-5250.2016.06.006

Objective

To investigate the clinical diagnosis value of serum glycocholic acid, total bile acid(TBA), alanine transarninase(ALT) and thyroid stimulating hormone(TSH) levels in intrahepatic cholestasis of pregnancy(ICP).

Methods

From January to December 2015, a total of 62 cases of ICP pregnant women(included in ICP group) and 1 160 healthy pregnant women at the same time in outpatient for antenatal examination(included in control group) in Tianmen First People′s Hospital of Hubei, were chosen as study objects.Detection serum glycocholic acid, TBA, ALT and TSH levels of all subjects.Compared the differences of 4 index levels above mentioned between two groups of pregnant women and parewise compared the 4 index between patients with different degrees of ICP by statistical method, also compared the difference of proportion of advanced age(≥35 years old) between two groups. There were no significant differences between two groups of pregnant women in general clinical data such as weight and gestational age, etc.(P>0.05).

Results

The serum glycocholic acid, TBA, ALT and TSH levels of ICP group patients were higher than those of control group, and the differences were statistically significant(P<0.05). The serum glycocholic acid content of mild ICP patients was lower than that of moderate ICP patients and higher than that of control group, and the differences were statistically significant(P<0.05). There were no significant differences between mild and moderate ICP patients or between mild ICP patients and control group in serum TBA, ALT and TSH levels(P>0.05). Serum glycocholic acid, TBA, ALT and TSH levels of mild ICP patients were lower than those of severe ICP patients, and the differences were statistically significant(P<0.05). The proportion of advanced age pregnant women of ICP group was higher than that of control group, and the difference was statistically significant(74.2% vs 34.2%, χ²= 195.87, P=0.002).

Conclusions

Serum glycocholic acid, TBA, ALT and TSH levels′ monitoring have significant value for the diagnosis of ICP. The detection of serum glycocholic acid content also can be used for the diagnosis of early mild ICP.

Key words: Glycocholic acid, Bile acids and salts, Alanine transaminase, Thyrotropin, Cholestasis, intrahepatic, Pregnant women

表1 ICP孕妇与健康孕妇之间及不同程度ICP患者两两之间血清甘胆酸、TBA、ALT及TSH水平比较(±s)

组别		例数	甘胆酸水平(mg/L)	TBA水平(μmol/L)	ALT水平(U/L)	TSH水平(mIU/L)
ICP组		62	54.2±8.3	37.4±6.1	105.8±12.3	5.3±1.9
?	重型	6	201.2±29.6	97.4±12.3	276.8±63.7	6.9±2.4
?	中型	36	51.2±12.3	36.4±6.1	95.8±12.3	5.9±1.6
?	轻型	20	15.6±1.1	18.3±2.7	49.6±7.4	3.2±0.9
对照组		1 160	1.6±0.6	8.3±1.1	29.6±2.4	1.8±0.9
t值^a		?	7.95	6.20	4.36	3.73
P值		?	0.036	0.041	0.042	0.044

表1 ICP孕妇与健康孕妇之间及不同程度ICP患者两两之间血清甘胆酸、TBA、ALT及TSH水平比较(±s)

组别		例数	甘胆酸水平(mg/L)	TBA水平(μmol/L)	ALT水平(U/L)	TSH水平(mIU/L)
ICP组		62	54.2±8.3	37.4±6.1	105.8±12.3	5.3±1.9
?	重型	6	201.2±29.6	97.4±12.3	276.8±63.7	6.9±2.4
?	中型	36	51.2±12.3	36.4±6.1	95.8±12.3	5.9±1.6
?	轻型	20	15.6±1.1	18.3±2.7	49.6±7.4	3.2±0.9
对照组		1 160	1.6±0.6	8.3±1.1	29.6±2.4	1.8±0.9
t值^a		?	7.95	6.20	4.36	3.73
P值		?	0.036	0.041	0.042	0.044

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