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妊娠期肝内胆汁淤积症中瘙痒与自分泌运动因子的关系。

Relationship between pruritus and autotaxin in intrahepatic cholestasis of pregnancy.

机构信息

Basaksehir Cam and Sakura City Hospital, Department of Gastroenterology, Istanbul, Turkey.

SBU Istanbul Kanuni Sultan Süleyman Training and Research Hospital, Department of Gastroenterology, Istanbul, Turkey.

出版信息

Gastroenterol Hepatol. 2021 Feb;44(2):96-102. doi: 10.1016/j.gastrohep.2020.08.001. Epub 2020 Oct 1.

Abstract

OBJECTIVE

Intrahepatic cholestasis of pregnancy is a temporary, pregnancy-specific disease that resolves with delivery, characterized by itching (pruritus), as well as high transaminase and serum bile acid levels in the third trimester of pregnancy. Due to the effects of Autotaxin on the physiology of pregnancy, we aimed to investigate Autotaxin activity in patients with intrahepatic cholestasis of pregnancy.

PATIENTS AND METHODS

Sixty-nine patients diagnosed with intrahepatic cholestasis of pregnancy and 20 healthy pregnant women were enrolled in the study. Fasting serum bile acid, pruritus intensity, serum parameters, gestational week of the patients at the time of diagnosis were recorded, and birth week and birth weight were monitored. Autotaxin serum level was measured enzymatically.

RESULTS

The mean serum bile acid level (n=69; 38.74±35.92μmol/L) in patients with intrahepatic cholestasis of pregnancy (n=69) was detected to be higher than healthy pregnant women (n=20; 5.05±1.88μmol/L) (p<0.001). Weak correlation was detected between serum bile acid level and itch intensity (p=0.014, r=0.295), while no relation was detected between Autotaxin and itch intensity (p=0.446, r=0.09). Although mean Autotaxin (intrahepatic cholestasis of pregnancy: 678.10±424.42pg/mL, control: 535.16±256.47pg/mL) levels were high in patients with intrahepatic cholestasis of pregnancy, it was not statistically significant (p=0.157).

CONCLUSION

In our study, we observed that the serum Autotaxin level did not make a significant difference in patients with intrahepatic cholestasis of pregnancy compared to healthy pregnant women. These findings suggest that larger clinical studies are required to reveal the physio-pathological effects of Autotaxin on pregnancy.

摘要

目的

妊娠肝内胆汁淤积症是一种特发性疾病,仅发生于妊娠妇女,分娩后可自行缓解,其特征为瘙痒(瘙痒症)以及妊娠晚期血清转氨酶和胆汁酸水平升高。由于 Autotaxin 对妊娠生理的影响,我们旨在研究妊娠肝内胆汁淤积症患者的 Autotaxin 活性。

方法

本研究纳入了 69 例妊娠肝内胆汁淤积症患者和 20 例健康孕妇。记录了患者的空腹血清胆汁酸、瘙痒强度、血清参数、诊断时的孕周,并监测了分娩周数和出生体重。通过酶法测量 Autotaxin 血清水平。

结果

妊娠肝内胆汁淤积症患者(n=69)的平均血清胆汁酸水平(n=69;38.74±35.92μmol/L)高于健康孕妇(n=20;5.05±1.88μmol/L)(p<0.001)。血清胆汁酸水平与瘙痒强度呈弱相关(p=0.014,r=0.295),而 Autotaxin 与瘙痒强度之间无相关性(p=0.446,r=0.09)。虽然妊娠肝内胆汁淤积症患者的平均 Autotaxin 水平(妊娠肝内胆汁淤积症:678.10±424.42pg/mL,对照组:535.16±256.47pg/mL)较高,但差异无统计学意义(p=0.157)。

结论

在本研究中,与健康孕妇相比,我们观察到妊娠肝内胆汁淤积症患者的血清 Autotaxin 水平没有显著差异。这些发现表明,需要进行更大的临床研究来揭示 Autotaxin 对妊娠的生理病理影响。

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