Heikkinen J, Mäentausta O, Tuimala R, Ylöstalo P, Jänne O
Obstet Gynecol. 1980 Jul;56(1):60-4.
Radioimmunologic techniques were used to determine 2 primary bile acids (cholic and chenodeoxycholic acid) and 1 secondary bile acid (deoxycholic acid) from human amniotic fluid of healthy pregnant women and from patients with diabetes, toxemia, or intrahepatic cholestasis during pregnancy. In general, the mean bile acid concentrations in the amniotic fluid were very similar to those in the serum, although in paired samples from individual patients these 2 values did not correlate significantly. Very high levels of the 2 primary bile acids were measured from the amniotic fluid of patients with intrahepatic cholestasis. The mean values were about 70 times higher than those in the controls. Amniotic fluid cholic acid content was slightly elevated in diabetic and toxemic patients, too. Deoxycholic acid was consistently found in the amniotic fluid specimens, but there was no change in its concentration among the various groups. In this limited series of patients, no significant correlation was found between the bile acid concentrations in the amniotic fluid and signs of fetal distress at the time of amniocentesis, although the lowest maternal serum estriol and human placental lactogen values were associated with the highest amniotic fluid bile acid concentrations. The condition of the newborn infants did not correlate with amniotic fluid bile acid concentrations in any of the patient groups studied. It thus appears that high amniotic fluid bile acid content present a threat to the fetus, but further studies are needed to clarify this point.
采用放射免疫技术测定了健康孕妇以及患有糖尿病、毒血症或妊娠肝内胆汁淤积症患者羊水内的2种初级胆汁酸（胆酸和鹅脱氧胆酸）和1种次级胆汁酸（脱氧胆酸）。总体而言，羊水内胆汁酸的平均浓度与血清中的非常相似，不过在个体患者的配对样本中，这两个值并无显著相关性。在妊娠肝内胆汁淤积症患者的羊水中检测到2种初级胆汁酸的含量非常高。其平均值比对照组高约70倍。糖尿病和毒血症患者羊水内的胆酸含量也略有升高。在羊水样本中始终能检测到脱氧胆酸，但其浓度在不同组之间并无变化。在这一有限的患者系列中，虽然孕妇血清雌三醇和人胎盘催乳素的最低值与羊水胆汁酸的最高浓度相关，但在羊膜穿刺时，羊水胆汁酸浓度与胎儿窘迫迹象之间未发现显著相关性。在所研究的任何患者组中，新生儿的状况与羊水胆汁酸浓度均无关联。因此，羊水胆汁酸含量高似乎对胎儿构成威胁，但还需要进一步研究来阐明这一点。
