南通地区妊娠期肝内胆汁淤积症发病情况及危险因素调查

发布时间：2018-11-28 20:07

【摘要】：目的:调查分析南通地区妊娠期肝内胆汁淤积症发病情况及其相关发病因素,为临床诊治提供依据。方法:搜集2011年1月至2015年12月南通地区住院孕妇的资料,统计妊娠期发现肝功能异常的病例数,分析其中妊娠期肝内胆汁淤积症患者所占比例,同时分析妊娠期肝内胆汁淤积症与年龄、孕前体重指数、胎次、不良妊娠史(自然流产或早产)、家族史、饮食、受精方式、激素保胎治疗、自身免疫性疾病、妊娠期高血压、妊娠期糖脂代谢异常等情况的相关性。结果:99 523例妊娠晚期孕妇中,肝损害3 712例(发病率为3.73%),其中妊娠期肝内胆汁淤积症998例(占26.89%)。单因素分析发现单胎及双胎以上妊娠、家族史、人工受精、激素保胎治疗、自身免疫性疾病、妊娠期高血压、妊娠期糖脂代谢异常与妊娠期肝内胆汁淤积症发病相关,进一步行多因素非条件Logistic回归分析结果显示,双胎以上妊娠、家族史、激素保胎治疗、自身免疫性疾病、妊娠期高血压是妊娠期肝内胆汁淤积症发病的危险因素,OR值分别为5.25、2.06、4.01、5.21、2.01,差异有统计学意义(P0.05)。结论:南通地区妊娠期肝内胆汁淤积症发病率较高,双胎及以上妊娠、家族史、激素保胎治疗、自身免疫性疾病、妊娠期高血压是其危险因素,在妊娠期肝内胆汁淤积症诊治中应引起重视。
[Abstract]:Objective: to investigate the incidence of intrahepatic cholestasis of pregnancy and its related factors in Nantong area. Methods: the data of hospitalized pregnant women in Nantong area from January 2011 to December 2015 were collected, and the number of cases with abnormal liver function during pregnancy were counted, and the proportion of patients with intrahepatic cholestasis of pregnancy was analyzed. At the same time, intrahepatic cholestasis of pregnancy and age, body mass index (BMI) before pregnancy, birth order, history of adverse pregnancy (spontaneous abortion or premature delivery), family history, diet, fertilization, hormone therapy, autoimmune diseases, hypertension complicating pregnancy were analyzed. Correlation of abnormal glucose and lipid metabolism during pregnancy. Results: of the 99 523 pregnant women in the third trimester of pregnancy, 3 712 (3.73%) had liver damage, of which 998 (26.89%) were intrahepatic cholestasis of pregnancy. Univariate analysis showed that single and twin pregnancies, family history, artificial insemination, hormone therapy, autoimmune diseases, gestational hypertension, abnormal glucose and lipid metabolism during pregnancy were associated with intrahepatic cholestasis of pregnancy. Further multivariate conditional Logistic regression analysis showed that the risk factors of intrahepatic cholestasis of pregnancy were twin pregnancy, family history, hormone therapy, autoimmune disease and hypertension of pregnancy. The OR values were 5.250.206 (4.01) and 5.21 (2.01), respectively. The difference was statistically significant (P0.05). Conclusion: the incidence of intrahepatic cholestasis of pregnancy is high in Nantong area. The risk factors are twin pregnancy, family history, hormone therapy, autoimmune disease and hypertension complicating pregnancy. Attention should be paid to the diagnosis and treatment of intrahepatic cholestasis of pregnancy.
【作者单位】：南通大学附属南通妇幼保健院消化内科;南通大学附属南通妇幼保健院妇女保健科;南通大学附属医院消化内科;
【分类号】：R714.255

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