Su Grace L
University of Michigan Medical School, Ann Arbor Veterans Administration Health Center, Gastroenterology Section 111D, 2215 Fuller Road, Ann Arbor, MI 48105, USA.
Curr Gastroenterol Rep. 2008 Feb;10(1):15-21. doi: 10.1007/s11894-008-0004-0.
Although liver disease does not occur frequently during pregnancy, when it does, it can cause significant morbidity and mortality for both fetus and mother. Recent advances in molecular genetics have provided some insight into the pathogenesis of diseases such as intrahepatic cholestasis of pregnancy (IHCP) and acute fatty liver of pregnancy. Newer studies linking serum bile acid levels with fetal outcome support the importance of this marker in IHCP. Randomized trials with ursodeoxycholic acid have shown promising results in reducing maternal symptoms and serum bile acid levels in IHCP. Although further studies must be performed, early strategies aimed at reducing viral loads in mothers may reduce perinatal transmission of hepatitis B.
虽然孕期肝病并不常见,但一旦发生,可能会对胎儿和母亲造成严重的发病和死亡风险。分子遗传学的最新进展为诸如妊娠肝内胆汁淤积症(IHCP)和妊娠急性脂肪肝等疾病的发病机制提供了一些见解。将血清胆汁酸水平与胎儿结局相关联的最新研究支持了该标志物在IHCP中的重要性。熊去氧胆酸的随机试验在减轻IHCP母亲症状和降低血清胆汁酸水平方面显示出了有希望的结果。虽然必须进行进一步研究,但旨在降低母亲病毒载量的早期策略可能会减少乙型肝炎的围产期传播。