SERUM BILE-ACID CONCENTRATIONS DURING PREGNANCY AND THEIR RELATIONSHIP TO OBSTETRIC CHOLESTASIS
SERUM BILE-ACID CONCENTRATIONS DURING PREGNANCY AND THEIR RELATIONSHIP TO OBSTETRIC CHOLESTASIS
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DOI：
10.1016/0016-5085(86)90682-7
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发表时间：
1986-10-01
期刊：
影响因子：
29.4
通讯作者：
OHALLORAN, M
中科院分区：
文献类型：
--
作者：
LUNZER, M;BARNES, P;OHALLORAN, M
我们前瞻性地研究了 297 名妊娠期间血清餐后甘胆酸 (CG) 浓度的变化。我们发现CG浓度从怀孕15周时的0.3μmol/L增加到怀孕40周时的0.6μmol/L。尽管这种增加具有统计学显着性（p < 0.005），但 CG 的中位浓度仍然很好地保持在正常范围内（0-1.5 μmol/L）。然而，该组中有10%的人在妊娠30周时表现出血清CG浓度明显升高，并且该组中的CG水平在妊娠晚期持续升高。 CG 浓度升高组 (48%) 的瘙痒明显高于 CG 水平正常组 (20%) (P < 0.005)。与其他生化肝脏检测相比，血清 CG 是妊娠期瘙痒的更敏感的预测指标。与其他种族的患者相比，地中海和亚洲患者的 CG 水平升高更为常见 (p < 0.025)。未发现CG浓度升高与母亲年龄、既往妊娠次数、既往妊娠期间瘙痒、避孕引起的胆汁淤积和胎儿成熟度之间存在统计学上的显着关联。我们得出的结论是：（a）产科胆汁淤积可能比以前怀疑的更为常见；（b）应考虑对所有患有不明原因瘙痒的孕妇进行血清胆汁酸测量。
We have prospectively studied changes in serum postprandial cholylglycine (CG) concentration during 297 pregnancies. We found an increase in CG concentration from 0.3 .mu.mol/L at 15 weeks'' pregnancy to 0.6 .mu.mol/L at 40 weeks'' pregnancy. Although this increase was statistically significant (p < 0.005), median concentrations of CG remained well within the normal range (0-1.5 .mu.mol/L). However, 10% of the group showed markedly elevated serum CG concentrations at 30 weeks pregnancy, and the CG level in this group continued to rise during the third trimester. Pruritus was significantly more common in the group with elevated CG concentrations (48%) than in the group with normal CG levels (20%) (P < 0.005). Serum CG was a much more sensitive predictor of pruritus during pregnancy than other biochemical liver tests. Elevated CG levels were found more commonly in Mediterranean and Asian patients than patients of other ethnic origins (p < 0.025). No statistically significant assocations were found between elevated CG concentrations and maternal age, number of previous pregnancies, pruritis during previous pregnancies, contraceptive-induced cholestasis, and fetal maturity. We conclude (a) that obstetric cholestasis is probably much more common than previously suspected and (b) that consideration should be given to the measurement of serum bile acids in all pregnant individuals with unexplained pruritus.