Qi Hong-bo, Shao Yong, Wu Wei-xin, Zhang Jian-hua
Department of Obstetrics and Gynecology, First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China.
Zhonghua Fu Chan Ke Za Zhi. 2004 Jan;39(1):14-7.
This study was to evaluate the grading of intrahepatic cholestasis of pregnancy (ICP).
All 278 ICP cases were collected in the First Affiliated Hospital of Chongqing Medical University between Jan 1999 and May 2003. They were graded into mild ICP and severe ICP based on liver function test. Outcome of pregnancy and perinatal mortality were assessed.
One hundred and ninety two cases were diagnosed as mild ICP while 86 cases were as severe ICP. There was significant difference in the average time of expectant therapy (10.3 +/- 4.8 vs 19.1 +/- 6.4 days) and gestational weeks (35.8 +/- 1.6 vs 37.7 +/- 1.9) between severe ICP and mild ICP groups (P < 0.01 and P < 0.001). The incidences of meconium passage, newborn asphyxia and admissions to neonatal intensive care unit in severe ICP were significantly higher than that in mild ICP. These were 38.4% vs 9.4%, 12.8% vs 4.2%, and 30.2% vs 9.4%, respectively. The difference of perinatal mortality between the patients with ICP diagnosed by using and not using the grading system (0.7% - 1.2% vs 3.9% - 6.0%) was statistically significant (P < 0.01).
Grading of ICP based on liver function test may improve perinatal prognosis.
本研究旨在评估妊娠期肝内胆汁淤积症（ICP）的分级。
收集1999年1月至2003年5月在重庆医科大学附属第一医院就诊的278例ICP患者。根据肝功能检查结果将其分为轻度ICP和重度ICP。评估妊娠结局和围产儿死亡率。
192例被诊断为轻度ICP，86例为重度ICP。重度ICP组和轻度ICP组在期待治疗的平均时间（10.3±4.8天对19.1±6.4天）和孕周（35.8±1.6周对37.7±1.9周）方面存在显著差异（P<0.01和P<0.001）。重度ICP组胎粪排出、新生儿窒息及入住新生儿重症监护病房的发生率显著高于轻度ICP组，分别为38.4%对9.4%、12.8%对4.2%、30.2%对9.4%。使用和未使用分级系统诊断的ICP患者围产儿死亡率差异有统计学意义（0.7%-1.2%对3.9%-6.0%，P<0.01）。
基于肝功能检查对ICP进行分级可能改善围产儿预后。
