妊娠肝内胆汁淤积症患者SIRI、pro-ADM、MDH1水平与妊娠结局的关系

doi:10.3760/cma.j.cn441417-20241111-08012

摘要/Abstract

摘要：

目的　研究全身炎症反应指数（SIRI）联合前促肾上腺素（pro‐ADM）、乳酸脱氢酶1（MDH1）水平与妊娠肝内胆汁淤积症（ICP）患者妊娠结局的关系。方法　采用回顾性研究，选取2021年7月至2024年6月西安市第三医院收治的124例ICP患者。根据妊娠结局分为不良组和良好组。不良组51例，年龄（28.94±3.27）岁，发病孕周（30.55±1.35）周；良好组73例，年龄（29.33±2.69）岁，发病孕周（31.12±1.29）周。比较两组患者发病孕周、发病程度、白蛋白（Alb）、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、总胆汁酸（TBA）、pro‐ADM、MDH1、SIRI水平。logistic回归分析ICP患者妊娠结局的影响因素，评估SIRI联合pro‐ADM、MDH1水平对不良妊娠结局的预测价值。统计学方法采用t检验、χ²检验。结果　不良组发病孕周低于良好组，重度发病占比、Alb、ALT、AST、TBA、pro‐ADM、MDH1、SIRI水平高于良好组，差异均有统计学意义（t=2.395，χ²=6.529，t=3.001、2.345、2.366、2.628、6.156、4.319、8.007，均P<0.05）。logistic分析结果显示，ICP患者发病孕周、发病程度、Alb、ALT、AST、TBA、pro‐ADM、MDH1、SIRI水平均是影响妊娠结局的重要因素（均P<0.05）。受试者操作特征曲线（ROC）结果显示，pro‐ADM、MDH1、SIRI联合的灵敏度和特异度分别为82.4%、93.2%。结论　pro‐ADM、MDH1、SIRI水平与ICP患者妊娠结局密切相关，提高监测有助于改善临床管理和预后。

关键词:

妊娠肝内胆汁淤积症, 全身炎症反应指数, 妊娠结局, 预测价值

Abstract:

Objective　To investigate the relationship of the levels of systemic inflammatory response index (SIRI), pro-adrenomedullin (pro‐ADM), and lactate dehydrogenase 1 (MDH1) with pregnancy outcomes in patients with intrahepatic cholestasis of pregnancy (ICP). Methods　This is a retrospective study. One hundred and twenty-four patients with ICP treated at Xi'an Third Hospital from July 2021 to June 2024 were selected, and were divided into an adverse outcome group (51 cases), who were (28.94±3.27) years old and (30.55±1.35) weeks pregnant, and a favorable outcome group (73 cases), who were (29.33±2.69) years old and (31.12±1.29) weeks pregnant. The onset weeks of pregnancy, disease severities, and levels of albumin (Alb), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bile acids, pro-ADM, MDH1, and SIRI were compared between the two groups. The logistic regression was used to analyze the factors affecting the patients' pregnancy outcomes. The predictive value of SIRI combined with pro-ADM and MDH1 for adverse pregnancy outcomes was assessed. t and χ² tests were used for the statistical analysis. Results　The adverse group had earlier onset of pregnancy, a higher proportions of severe case, and higher levels of Alb, ALT, AST, total bile acids, pro-ADM, MDH1, and SIRI than the favorable group (t=2.395; χ²=6.529; t=3.001, 2.345, 2.366, 2.628, 6.156, 4.319, and 8.007; all P<0.05). The logistic analysis indicated that the onset weeks of pregnancy, disease severity, and levels of Alb, ALT, AST, total bile acids, pro-ADM, MDH1, and SIRI were significant factors influencing pregnancy outcomes (all P<0.05). The receiver operating characteristic curve showed that the combination of pro-ADM, MDH1, and SIRI had a sensitivity of 82.4% and a specificity of 93.2%. Conclusions　The levels of pro-ADM, MDH1, and SIRI are closely related to pregnancy outcomes in patients with ICP. Enhancing monitoring of these markers can improve clinical management and their prognosis.

Key words:

Intrahepatic cholestasis of pregnancy, Systemic inflammatory response index, Pregnancy outcomes, Predictive value

王亚桃李锋饶周舟.

妊娠肝内胆汁淤积症患者SIRI、pro-ADM、MDH1水平与妊娠结局的关系 [J]. 国际医药卫生导报, 2025, 31(8): 1287-1291.

Wang Yatao, Li Feng, Rao Zhouzhou.

Relationship of levels of SIRI, pro-ADM, and MDH1 with pregnancy outcomes in patients with intrahepatic cholestasis of pregnancy [J]. International Medicine and Health Guidance News, 2025, 31(8): 1287-1291.

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