Yayla Abide Çiğdem, Vural Fisun, Kılıççı Çetin, Bostancı Ergen Evrim, Yenidede İlter, Eser Ahmet, Pekin Oya
University of Health Sciences, Zeynep Kamil Women and Children's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey.
University of Health Sciences, Haydarpaşa Numune Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey.
Turk J Obstet Gynecol. 2017 Sep;14(3):160-165. doi: 10.4274/tjod.67674. Epub 2017 Sep 30.
To investigate the association of inflammatory markers with severity of intrahepatic cholestasis of pregnancy (ICP).
This retrospective case-control study was conducted with 229 pregnant women, 84 with ICP, and 145 age-matched healthy pregnant women. Patients were categorized as mild ICP (<40 µmol/L) and severe ICP (≥40 µmol/L) with regard to serum bile acids. Inflammatory markers (neutrophil-to-lymphocyte ratio (NLR), platelet-to- lymphocyte ratio (PLR) and mean platelet volume (MPV), and red blood cell distribution width (RDW) were compared between the groups.
Patients with ICP had significantly decreased RDW and increased white blood cell counts (WBC), MPV and PLR, but no significant changes in NLR. The comparison of mild and severe cases with regard to NLR, PLR, WBC, and RDW was similar (p>0.05). MPV levels were significantly increased in severe group (p<0.05).
WBC, MPV, and PLR were the inflammatory markers significantly increased, and RDW was signifantly reduced in ICP. MPV was the marker that significantly increased with the severity of disease. The use of inflammatory markers in the assessment of perinatal outcomes needs further studies.
探讨炎症标志物与妊娠肝内胆汁淤积症（ICP）严重程度的相关性。
本回顾性病例对照研究纳入了229例孕妇，其中84例为ICP患者，145例为年龄匹配的健康孕妇。根据血清胆汁酸水平将患者分为轻度ICP（<40 µmol/L）和重度ICP（≥40 µmol/L）。比较两组间的炎症标志物（中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、平均血小板体积（MPV）和红细胞分布宽度（RDW））。
ICP患者的RDW显著降低，白细胞计数（WBC）、MPV和PLR升高，但NLR无显著变化。轻度和重度病例在NLR、PLR、WBC和RDW方面的比较相似（p>0.05）。重度组的MPV水平显著升高（p<0.05）。
WBC、MPV和PLR是ICP中显著升高的炎症标志物，而RDW显著降低。MPV是随疾病严重程度显著升高的标志物。炎症标志物在围产期结局评估中的应用需要进一步研究。
