目的:測(cè)定妊娠期肝內(nèi)膽汁淤積癥(ICP)患者血清及尿液的膽汁酸水平,探討ICP時(shí)母體膽汁酸轉(zhuǎn)運(yùn)的變化及意義。方法:ICP患者(ICP組)及正常妊娠(對(duì)照組)各20例。血清及尿液總膽汁酸測(cè)定采用速率法。結(jié)果:(1)ICP組與對(duì)照組相比,血清及尿液中總膽汁酸水平均明顯升高,差異有顯著性(P lt;0.05);(2)對(duì)照組尿液總膽汁酸水平明顯高于血清,差異有顯著性(P lt;0.05),而ICP組血清和尿液總膽汁酸水平無(wú)顯著性差異(P gt;0.05);(3)兩組中血清與尿液總膽汁酸水平均無(wú)相關(guān)性(P gt;0.05)。結(jié)論:ICP患者母血中總膽汁酸水平明顯增加,而總膽汁酸經(jīng)尿液的排泄未成比例增加,這可加重膽汁淤積,引起圍產(chǎn)兒不良結(jié)局。
引用本文: 徐洲,邢愛(ài)耘,萬(wàn)紅芳,王利民. 妊娠肝內(nèi)膽汁淤積癥尿液總膽汁酸變化及意義. 華西醫(yī)學(xué), 2009, 24(2): 317-319. doi: 復(fù)制
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- 1. Glantz A,Marschall HU,Mattsson LA.Intrahepatic cholestasis of pregnancy:Relationships between bile acid levels and fetal complication rates[J].Hepatology,2004,40:467-474..
- 2. Reyes H.The spectrum of liver and gastrointestinal disease seen in cholestasis of pregnancy[J].Gastroenterol Clin North Am,1992,21:905-921..
- 3. Raedsch R,Lauterburg BH,Hofmann AF.Altered bile acid metabolism in primary biliary cirrhosis[J].Dig Dis Sci,1981,26:394-401.
- 4. Colombo C,Roda A,Roda E,et al.Correlation between fetal and meternal serum bile acid concentrations[J].Pediatr Res,1985,19:227-231..
- 5. Mazzella G,Nicola R,F(xiàn)rancesco A,et al.Ursodexycholic acid administration in patients with cholestasis of pregnancy:effects on primary bile acids in babies and mothers[J].Hepatology,2001,33:504-8.
- 6. Williamson C,Gorelik J,Eaton BM,et al.The bile acid taurocholate impairs rat cardiomyocyte function:a proposed mechanism for intrauterine fetal death in obstetric cholestasis[J].Clin sci,2001;100:363-369..
- 7. Aguilar Spivey JR.In vitro studies of bile salt toxicity[J].Hepatology,1994,19:1538-1541..
- 8. 夏松云,陳竹欽,李力.妊娠期肝內(nèi)膽汁淤積癥患者胎盤(pán)血管內(nèi)皮生長(zhǎng)因子的變化及其意義[J].中國(guó)醫(yī)師雜志,2003,8:1068-70..
- 9. Thomassen PA.Urinary bile acids during development of recurrent cholestasis of pregnancy[J].Eur J Clin Invest,1979,9(6):417-23..
- 10. Carddock AL,Love MW,Daniel RW,et al.Expression and transport properties of the human ileal and renal sodiumdependent bile acid transporter[J].Am J Physiol Gastrointest Liver Physiol,1998,278:G157-G169..
- 11. Kullakublick GA,Hagenbuch B,Stieger B,et al.Molecular and functional characterization of an organic anion transporting polypeptide cloned from human liver[J].Gastroenterology,1995,109:1274-1282..
- 12. Schaub TP,Kartenbeck J,Konig J,et al.Expression of the MRP2 geneencoded conjugate export pump in human kidney proximal tubules and in renal cell carcinoma[J].J Am Soc Nephrol,1999,10:1159-1169..
- 13. Soroka CJ,Cai SY,Boyer JL.Effects of cholestasis on the regulation of membrane transporter expression in intestine and kidney(Abstract)[J].Hepatology,2002,36:462A..
- 14. Oelkers P,Kirby LC,Heubi JE,et al.Primary bile acid malabsorption caused by mutations in the ileal sodiumdependentbile acid transporter gene(SLC10A2)[J].J Clin Invest,1997,99:1880-1887..