• 1.四川大學(xué)華西第二醫(yī)院婦產(chǎn)科，四川成都 610041;2.四川省婦幼保健院婦產(chǎn)科，四川成都 61003;

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,邢愛耘,萬紅芳,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

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 intrauterine 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血管內(nèi)皮生長因子的變化及其意義[J].中國醫(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 sodiumdependent bile acid transporter[J].Am J Physiol Gastrointest Liver Physiol，1998，278：G157-G169..
11. Kullakublick 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 geneencoded 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 sodiumdependentbile acid transporter gene(SLC10A2)[J].J Clin Invest，1997，99：1880-1887..
  1. 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. 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. 3. Raedsch R，Lauterburg BH，Hofmann AF.Altered bile acid metabolism in primary biliary cirrhosis[J].Dig Dis Sci，1981，26：394-401.
  4. 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. 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. 6. Williamson C，Gorelik J，Eaton BM，et al.The bile acid taurocholate impairs rat cardiomyocyte function：a proposed mechanism for intrauterine fetal death in obstetric cholestasis[J].Clin sci，2001；100：363-369..
  7. 7. Aguilar Spivey JR.In vitro studies of bile salt toxicity[J].Hepatology，1994，19：1538-1541..
  8. 8. 夏松云，陳竹欽，李力.妊娠期肝內(nèi)膽汁淤積癥患者胎盤血管內(nèi)皮生長因子的變化及其意義[J].中國醫(yī)師雜志，2003，8：1068-70..
  9. 9. Thomassen PA.Urinary bile acids during development of recurrent cholestasis of pregnancy[J].Eur J Clin Invest，1979，9(6)：417-23..
  10. 10. Carddock AL，Love MW，Daniel RW，et al.Expression and transport properties of the human ileal and renal sodiumdependent bile acid transporter[J].Am J Physiol Gastrointest Liver Physiol，1998，278：G157-G169..
  11. 11. Kullakublick 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. 12. Schaub TP，Kartenbeck J，Konig J，et al.Expression of the MRP2 geneencoded conjugate export pump in human kidney proximal tubules and in renal cell carcinoma[J].J Am Soc Nephrol，1999，10：1159-1169..
  13. 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. 14. Oelkers P，Kirby LC，Heubi JE，et al.Primary bile acid malabsorption caused by mutations in the ileal sodiumdependentbile acid transporter gene(SLC10A2)[J].J Clin Invest，1997，99：1880-1887..