摘要
目的分析妊娠期发生ICP的相关风险因素,对妊娠期发生ICP的风险进行早期预测。方法收集2018年5月至2023年5月上海市公共卫生临床中心收治的300例妊娠期肝内胆汁淤积症病例为ICP组,同期收治的300正常孕妇为对照组,临床病例资料完整,进行回顾性分析。结果ICP组孕妇的临床特征中年龄大于30岁、既往ICP病史、皮肤瘙痒、孕前BMI>24、妊娠期高血糖、甲状腺疾病、辅助生殖及多胎发生率明显高于对照组,差异有统计学意义(P<0.05),以上临床特征指标是孕期发生ICP的风险因素。临床特征构建的列线图可以预测发生ICP的风险。Lasso-Logistic回归分析结果显示化验指标肝功能(ALT、TBIL)、血脂(TG)、凝血功能(FIB)是孕期发生ICP的风险因素(P<0.05)。以上化验指标绘制的ROC曲线对发生ICP的风险有较好的预测价值。结论孕妇的部分临床特征及化验指标(ALT、TBIL、TG及FIB)是孕期发生ICP的风险因素。
Objective To analyze the risk related factors of ICP and to make early prediction of ICP in pregnancy.Methods A total of 300 cases of intrahepatic cholestasis of pregnancy admitted to Shanghai Public Health Clinical Center from May 2018 to May 2023 were collected as ICP group, and 300 normal pregnant women admitted during the same period were selected as control group.The clinical data were complete and retrospectively analyzed.Results The clinical characteristics of pregnant women in ICP group were older than 30 years old, ICP history, pruritus, pre-pregnancy BMI greater than 24,hyperglycemia during pregnancy, thyroid disease, assisted reproduction and the incidence of multiple births were significantly higher than those in the control group, and the difference between the two groups was statistically significant(P<0.05).These indicators were risk factors for ICP during pregnancy;A nomogram constructed of clinical features can predict the risk of ICP.Lasso-Logistic regression analysis showed that liver function(ALT,TBIL),blood lipid(TG) and coagulation function(FIB) were were risk factors for ICP during pregnancy(P<0.05);The ROC curve plotted by the assay can predict the risk of ICP.Conclusion Some clinical features and laboratory indicators(ALT、TBIL、TG、FIB) of pregnant women are risk factors for ICP during pregnancy.
作者
刘晶华
刘耀丹
刘敏
张晓红
LIU Jinghua;LIU Yaodan;LIU Min;ZHANG Xiaohong(Department of Obstetrics and Gynecology,Public Health Clinical Center Affiliated to Fudan University,Shanghai,201508,China)
出处
《中国实验诊断学》
2024年第6期631-636,共6页
Chinese Journal of Laboratory Diagnosis
基金
上海市卫生健康委员会科研项目(202240300)。
