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目的探讨母亲妊娠期肝内胆汁淤积症(ICP)对新生儿肝功能和肿瘤坏死因子-α(TNF-α)的影响。方法选择2009年3月至2010年8月在我院行剖宫产的ICP产妇所生的足月新生儿60例为观察组,因骨盆狭窄、臀位等行剖宫产的足月新生儿60例为对照组,分别测定并比较两组脐动脉血清胆汁酸(TBA)、pH值、谷丙转氨酶(ALT)、谷草转氨酶(AST)、乳酸脱氢酶(LDH)和TNF-α水平。结果观察组脐动脉血清TBA、ALT、AST、LDH、TNF-α均明显高于对照组[TBA:(11.9±1.8)μmol/L比(5.0±0.8)μmol/L,ALT:(232.6±17.9)U/L比(104.9±19.0)U/L,AST:(175.4±12.7)比(91.3±7.8)U/L,LDH:(417.7±10.5)IU/L比(233.1±15.6)IU/L,TNF-α:(11.1±1.5)ng/ml比(6.9±1.7)ng/ml,P均<0.05],pH值低于对照组[(7.22±0.10)比(7.25±0.03),P<0.05]。结论母亲ICP可能引起新生儿肝功能异常和TNF-α分泌增加。
Objective To investigate the effect of maternal pregnancy intrahepatic cholestasis (ICP) on liver function and tumor necrosis factor-α (TNF-α) in neonates. Methods Sixty-four full-term newborns born from ICP maternal cesarean section in our hospital from March 2009 to August 2010 were selected as the observation group. Full-term newborns with cesarean section due to pelvic stenosis, Sixty control subjects were included in this study. Serum bile acid (TBA), pH, ALT, AST, LDH and TNF-α were measured and compared in two groups. Results The serum levels of TBA, ALT, AST, LDH and TNF-α in the observation group were significantly higher than those in the control group [TBA: (11.9 ± 1.8) μmol / L vs 5.0 ± 0.8 μmol / L, (104.9 ± 19.0) U / L, AST: (175.4 ± 12.7) vs (91.3 ± 7.8) U / L, LDH: (417.7 ± 10.5) IU / L (P <0.05), and the level of TNF-α was (11.1 ± 1.5) ng / ml (6.9 ± 1.7) ng / 0.05]. Conclusion Maternal ICP may cause neonatal liver dysfunction and increase the secretion of TNF-α.