Abstract
目的 探讨妊娠肝内胆汁淤积症(ICP)胎儿总胆汁酸浓度与胎儿肾上腺皮质功能变化的关系.方法采用放射免疫法测定正常孕妇22例(对照组)及ICP孕妇20例(ICP组)胎儿脐血皮质醇及硫酸脱氢表雄酮(DHEA-S)浓度;循环酶法测定两组母血及脐血总胆汁酸浓度.结果ICP组胎儿脐血总胆汁酸浓度(8.93±3.16)mmol/L高于对照组(4.33±1.51) mmol/L,两组比较有显著性差异(P＜0.05),且与母血胆汁酸浓度呈正相关.ICP组脐血皮质醇浓度(99.83±41.34)ng/ml与对照组(74.93±29.58)ng/ml相比无明显差别(P＞0.05).ICP组脐血DHEA-S浓度(24.62±8.89)μg/dl明显低于对照组(69.18±39.37)μg/dl,两组比较有显著性差异(P＜0.05).ICP组脐血DHEA-S与皮质醇比值(0.29±0.09)亦明显低于对照组(0.87±0.31),两组比较有显著性差异(P＜0.05).ICP组脐血皮质醇、DHEA-S浓度及DHEA-S与皮质醇比值均与脐血胆汁酸浓度相关(相关系数分别为:r1=0.87,r2=-0.88,r3=-0.84;P＜0.05). 结论ICP孕妇的胎儿总胆汁酸浓度增高,与母血总胆汁酸浓度呈正相关;ICP孕妇的胎儿肾上腺皮质功能受损,其受损程度与脐血总胆汁酸浓度呈正相关。
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