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目的:分析抑制素A(INHA)在妊娠期肝内胆汁淤积症患者(ICP)外周血清中的水平及其与雌二醇(E2)和孕酮(P0)的相关性,探讨INHA、E2、P0与ICP发病的关系。方法:筛选出ICP研究组56例(其中重度ICP组23例,轻度ICP组33例)和正常对照组32例的外周血,采用间接ELISA法进行血清INHA、E2、P0水平测定。结果:轻度ICP组INHA值(144.72±37.75 ng/L)和重度ICP组INHA值(193.19±40.76 ng/L)均高于正常对照组(85.13±11.99 ng/L),差异均有统计学意义(P<0.01);根据正常对照组E2均值计算阳性的Cut off值,轻度ICP组、重度ICP组E2阳性率和正常对照组E2阳性率分别为63.6%、65.2%、12.5%,差异具有统计学意义(P<0.05);根据正常对照组P0均值计算阳性的Cut off值,轻度ICP组、重度ICP组P0阳性率和正常对照组P0阳性率分别为63.6%、69.6%、6.2%,差异具有统计学意义(P<0.05);轻度ICP组外周血INHA水平与E2、P0水平呈明显正相关(P<0.05),重度ICP组外周血INHA水平与E2水平呈明显正相关(P<0.05),正常对照组INHA水平与E2、P0水平不具有明显相关性(P>0.05)。结论:INHA、E2、P0升高与ICP相关,在妊娠期常规检测血清INHA、E2、P0,对产前保健工作具有重要意义。
Objective: To investigate the correlation between the level of inhibin A (INHA) in peripheral blood serum of patients with intrahepatic cholestasis of pregnancy (ICP) and its correlation with estradiol (E2) and progesterone (P0) Relationship between P0 and ICP. Methods: Peripheral blood samples were collected from 56 ICP patients (23 in severe ICP group, 33 in mild ICP group) and 32 normal controls. Serum levels of INHA, E2 and P0 were determined by indirect ELISA. RESULTS: The values of INHA in mild ICP group (144.72 ± 37.75 ng / L) and INHA group (193.19 ± 40.76 ng / L) in severe ICP group were significantly higher than those in control group (85.13 ± 11.99 ng / L) (P <0.01). The positive Cutoff value was calculated based on the mean of E2 in normal control group. The positive rates of E2 in mild ICP group and severe ICP group were 63.6%, 65.2% and 12.5%, respectively (P <0.05). According to the mean value of P0 in normal control group, the positive Cutoff value was calculated. The positive rate of P0 in mild ICP group and severe ICP group was 63.6%, and the positive rate of P0 was 69.6%, 6.2 %, P <0.05). The level of INHA in peripheral blood was positively correlated with the level of E2 and P0 in mild ICP group (P <0.05), while the levels of INHA in peripheral blood in ICP group were positively correlated with E2 (P <0.05). There was no significant correlation between INHA level and E2 and P0 levels in normal control group (P> 0.05). CONCLUSION: Elevated INHA, E2 and P0 are correlated with ICP, and routine testing of serum INHA, E2 and P0 during pregnancy is of great significance for prenatal care.