妊娠期无症状高胆汁酸血症的研究进展

doi:10.12280/gjfckx.20210365

摘要/Abstract

摘要：

妊娠期无症状高胆汁酸血症（asymptomatic hypercholanaemia of pregnancy,AHP）指妊娠期出现血清总胆汁酸升高,超过正常值2倍以上,无肝胆疾病或妊娠期肝内胆汁淤积症（intrahepatic cholestasis of pregnancy,ICP）相关症状。AHP发病率高于ICP,可能与激素因素及遗传易感性有关,其胆汁酸质谱构成与ICP不同,但围生结局好于ICP。总胆汁酸水平较高的AHP在临床上常难与重度ICP鉴别,导致提前终止妊娠,甚至医源性早产。因此,早期发现并正确诊断AHP,选择合适治疗方法及恰当终止妊娠时机,以降低医源性干预及早产是关键。就AHP的病因、发病机制、诊断和治疗进行综述。

关键词: 妊娠期无症状高胆汁酸血症, 妊娠期肝内胆汁淤积症, 胆汁淤积,肝内, 妊娠结局, 治疗

Abstract:

Asymptomatic hypercholanaemia of pregnancy (AHP) refers to the increase of serum total bile acids during pregnancy, which exceeds the normal value by more than two times, without hepatobiliary diseases or intrahepatic cholestasis of pregnancy (ICP)-related symptoms. The incidence of AHP is higher than ICP, which may be related to hormone factors and genetic susceptibility. The composition of bile acid mass spectrometry is different from ICP, but the perinatal outcome is better than ICP. AHP with high total bile acid level is often difficult to differentiate from severe ICP in clinic, which leads to premature termination of pregnancy and even iatrogenic premature birth. Therefore, early detection and correct diagnosis of AHP, selection of appropriate treatment methods and appropriate timing of termination of pregnancy are the key to reduce iatrogenic intervention and premature delivery. In this paper, the etiology, pathogenesis, diagnosis and treatment of AHP are summarized.

Key words: Asymptomatic hypercholanaemia of pregnancy, Intrahepatic cholestasis of pregnancy, Cholestasis,intrahepatic, Pregnancy outcome, Therapy

罗挺, 郭雪冬, 白晓霞. 妊娠期无症状高胆汁酸血症的研究进展[J]. 国际妇产科学杂志, 2021, 48(5): 499-502.

LUO Ting, GUO Xue-dong, BAI Xiao-xia. Research Progress of Asymptomatic Hypercholanaemia of Pregnancy[J]. Journal of International Obstetrics and Gynecology, 2021, 48(5): 499-502.

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