欢迎来到天天文库
浏览记录
ID:54927159
大小:360.24 KB
页数:4页
时间:2020-05-04
《妊娠期肝内胆汁淤积症对母儿的影响及其机制-论文.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、·154·国际妇产科学杂志2014年4月第41卷第2期JlntObstetGynecol,April2014,Vo1.41,No.2·综述·妊娠期肝内胆汁淤积症对母儿的影响及其机制伍思玲,邵勇,何芳【摘要】妊娠期肝内胆汁淤积症(ICP)~母儿均有不良影响。ICP患者妊娠中晚期体内激素水平异常、基因变异、免疫损伤及致痒源释放增多可引起母体皮肤瘙痒、胆汁酸水平升高及肝功能异常、凝血功能障碍及产后出血,孕妇预后佳,主要危及胎儿。类固醇物质代谢障碍、胆汁酸浓度升高可增加子宫肌层对催产素的敏感性、促进宫颈成熟,诱发早产;胆汁酸在组织器官中沉积导致胎盘绒毛血管痉挛、胎盘储备能力下降,通过
2、胎儿心脏及肺脏毒性作用引起胎儿窘迫、死产及新生儿死亡。【关键词】胆汁淤积,肝内;胆汁酸类和盐类;胎儿窘迫;呼吸窘迫综合征,新生儿;妊娠期肝内胆汁淤积症IntrahepaticCholestasisofPregnancy:MechanismandImpactsinPregnancyandFetalOutcomesWUSi—ling.SHA0Yong,HEFang.DepartmentofObstetricsandGynecology,TheFirstAfiliatedHospitalofChongqingMedicalUniversity,Chongqing400016,Chi
3、na(WUSi—ling,SHAOYong);DepartmentofObstetricsandGynecology,FulingHospitalofTrandhionalChineseMedicine,Chongqing408000,China(HEFang)Correspondingauthor:SHA0y0,E—mail:cqshaoyong@163.corn【Abstract】Intrahepaticcholestasisofpregnancyischaracterizedwithunexplainedpruritus,elevatedconcentrationoft
4、otalbileacidandlivertransaminases,whichareinfluencedbyabnormalhormonelevelinthesecondorthirdtrimester,genemutation,immuneinjuryandincreasedreleaseofprnritogens.Ahhoughithasgoodprognosisonpregnantwomen,itplaysanimportantroleonincreasedriskofadversefetaloutcomes,includingpretermdelivery,fetal
5、distress,fetalmortalityandneonatalrespiratorydistresssyndrome.TheabnormalmetabolismofsteroidsandelevatedtotalbileacidincreasemyometrialsensitivityforoxytocinandpromotecervicalripeningSOastoinduceprematuredelivery.Bileaciddespositionintheplacentaleadstospasmofplacentalvillousvesselsanddecrea
6、singplacentalreservecapacity.Also,bileacidaccumulationcanplayatoxinroleonfetalheartandlung,resuhingincardiacconductiondysfunctionandreducedsynthesisofpulmonarysurfactant.Allthesecontributetoincreasedrateoffetaldistress,fetaldeathandneonatallunginjury.【Keywords】Cholestasis,intrahepatic;Bilea
7、cidsandsalts;Fetaldistress;Respiratorydistresssyndrome,newborn;Intrahepaticcholestasisofpregnancy(JIntObstetGynecol,2014,41:154一l57)妊娠期肝内胆汁淤积症(intrahepaticcholestasis1ICP对母体的影响ofpregnancy,ICP)主要发生在妊娠中晚期,以皮肤瘙1.1皮肤瘙痒ICP患者皮肤瘙痒主要由胆汁酸、痒、胆汁酸和(或)转氨酶升高为主要特征,孕妇预后
此文档下载收益归作者所有