妊娠期肝内胆汁淤积症孕妇血清总胆汁酸水平与胎儿死亡关系的系统评价

发布时间：2018-07-04 15:01

  本文选题：妊娠期肝内胆汁淤积症 + 胎儿死亡　； 参考：《重庆医科大学》2014年硕士论文

【摘要】：目的利用系统评价的方法探讨ICP孕妇血清TBA水平与胎儿死亡之间的关系。 方法：通过检索有关ICP及血清TBA水平与胎儿死亡之间的关系的病例对照研究文献、个案报告文献及病例总结文献。通过Revman5.2软件对可合并的病例对照文献进行荟萃分析，对于不能合并分析的病例对照文献、个案报告及病例总结文献，利用描述性系统评价方法进行文献评价。 结果共纳入文献18篇。根据荟萃分析结果，ICP孕妇围产儿死亡的发生率为1.91%，与正常妊娠孕妇相比，ICP患者胎儿死亡的发病率有显著统计学差异（OR2.6595%CI1.66-4.24P0.0001）；对于ICP患者，当孕妇血清TBA≥40μmol/L时，胎儿死亡风险显著升高（OR11.51P=0.0001）。根据描述性系统评价结果，纳入不能合并分析ICP死胎文献6篇，共包含26例胎儿死亡病例，对孕妇血清TBA平进行描述，其TBA水平均明显升高，绝大多数大于40μmol/L，但TBA水平小于40μmol/L时，亦可发生胎儿死亡。1篇病例对照文献比较分析所有死胎及活产病例母血TBA水平差异，，共纳入死胎病例581例，活产病例1564例，其平均TBA水平均正常，两者比较，TBA水平无统计学差异。 结论系统评价文献表明ICP孕妇血清TBA水平超过40μmol/L时胎儿死亡风险增高，但ICP孕妇血清TBA水平低于40μmol/L时仍应警惕胎儿死亡的可能。
[Abstract]:Objective to study the relationship between serum TBA level and fetal death in ICP pregnant women. Methods: a case-control study on the relationship between ICP and serum TBA levels and fetal death was conducted. A meta-analysis was carried out on the combined case-control literature by Revman 5.2 software. For the case control literature, case report and case summary literature that could not be combined, the descriptive system evaluation method was used to evaluate the literature. Results A total of 18 articles were included. According to the results of meta-analysis, the perinatal mortality rate of ICP pregnant women was 1.91. The incidence of fetal death in ICP patients was significantly different from that in normal pregnant women (OR 2.6595CI1.66-4.24P0.0001), and for ICP patients, when the serum TBA was 鈮

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