2021 年第 2 期 第 16 卷

血清脂肪细胞型脂肪酸结合蛋白水平与妊娠期肝内胆汁淤积症的相关性

Correlation between serum adipocyte fatty acid binding protein level and intrahepatic cholestasis of pregnancy

作者：李俊林1许旭2卢霞2焦玉洁3

英文作者：Li Junlin1 Xu Xu2 Lu Xia2 Jiao Yujie3 

单位： 1乌鲁木齐市妇幼保健院产科830001；2新疆医科大学第六附属医院妇产科，乌鲁木齐830000；3新疆医科大学公共卫生学院儿少与妇幼卫生学教研室，乌鲁木齐830011

英文单位：1Department of Obstetrics Maternal and Child Health Hospital of Urumqi Urumqi 830001 China; 2Department of Obstetrics and Gynecology the Sixth Affiliated Hospital of Xinjiang Medical University Urumqi 830000 China; 3Teaching and Research Office of Children and Maternal Health School of Public Health Xinjiang Medical University Urumqi 830011 China

关键词：肝内胆汁淤积症；妊娠期；脂肪细胞型脂肪酸结合蛋白；肝功能；总胆汁酸

英文关键词：Intrahepaticcholestasis;Pregnancy;Adipocytefattyacidbindingprotein;Liverfunction;Totalbileacid

• 摘要：

• 目的 探讨血清脂肪细胞型脂肪酸结合蛋白（AFABP）与妊娠期肝内胆汁淤积症（ICP）的相关性。方法 回顾性收集2018年2月至2019年12月乌鲁木齐市妇幼保健院确诊的97例ICP患者（ICP组）的病历资料，另收集同期于乌鲁木齐市妇幼保健院接受产前检查的健康孕妇50例作为健康对照组。比较2组肝功能指标［丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素、直接胆红素（DBIL）、甘胆酸、血清总胆汁酸］及AFABP水平，比较不同严重程度ICP孕妇上述指标。分析ICP孕妇血清AFABP水平与肝功能指标及血清总胆汁酸水平的相关性。分析血清AFABP对ICP发生的影响和预测ICP发生的价值。结果 ICP组ALT、AST、总胆红素、DBIL、甘胆酸、总胆汁酸、AFABP水平均高于健康对照组，差异均有统计学意义（均P＜0.001）。97例ICP患者中轻度ICP组50例，重度ICP组47例。重度ICP组ALT、AST、总胆红素、DBIL、甘胆酸、总胆汁酸、AFABP水平均高于轻度ICP组，差异均有统计学意义（均P＜0.001）。双变量Pearson相关性分析结果显示，ICP患者的血清AFABP水平与ALT、AST、总胆红素、DBIL、甘胆酸、总胆汁酸水平均呈正相关（r=0.876、0.931、0.959、0.952、0.941、0.670，均P＜0.001）。血清AFABP过表达可能是诱发ICP的影响因素（比值比=1.351，95%置信区间：1.224～1.490，P＜0.001）。血清AFABP水平预测ICP发生的受试者工作特征曲线下面积为0.902（95%置信区间：0.853～0.951），最佳阈值为25.46 μg/L。结论 ICP患者血清AFABP水平多呈高表达，高水平AFABP可能参与ICP的发生与发展，与患者肝功能指标水平均呈正相关，用于预测早期ICP风险及病情严重程度评估有一定价值。

• Objective To investigate the correlation between the level of serum adipocyte fatty acid binding protein (AFABP) and intrahepatic cholestasis of pregnancy (ICP). Methods The medical data of 97 patients with ICP confirmed in Maternal and Child Health Hospital of Urumqi from February 2018 to December 2019 were retrospectively collected as ICP group, and 50 healthy pregnant women with pregnancy examination in the hospital during the same period were taken as healthy control group. The liver function indexes ［alanine transaminase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), direct bilirubin (DBIL), cholyglycine (CG), serum total bile acids (TBA)］ and AFABP levels were compared between the two groups. The correlation between serum AFABP level and liver function indexes and serum TBA level in ICP patients were analyzed. The effect of serum AFABP on the occurrence of ICP and the value of predicting the occurrence of ICP were analyzed. Results  The ALT, AST, TBIL, DBIL, CG, TBA and AFABP levels in ICP group were higher than those in healthy control group (all P＜0.05). According to the liver function index, 97 ICP patients were divided into mild group(50 cases) and severe group(47 cases). The levels of ALT, AST, TBIL, DBIL, CG, TBA and AFABP in severe group were higher than those in mild group (all P＜0.001). Bivariate Pearson correlation test showed that serum AFABP level was positively correlated with ALT, AST, TBIL, DBIL, CG, and TBA levels (r=0.876, 0.931, 0.959, 0.952, 0.941, 0.670, all P＜0.001). The overexpression of serum AFABP might be the risk factor for ICP (odds ratio =1.351， 95% confidence interval： 1.224-1.490，P＜0.001).The receiver operating characteristic curve showed that the area under curve of serum AFABP in predicting the occurrence of ICP was 0.902 (95% confidence interval:0.853-0.951), and the optimal threshold was 25.46 μg/L. Conclusions The levels of serum AFABP in patients with ICP are mostly highly expressed, and high levels of AFABP may be involved in the occurrence and development of ICP. AFABP is positively correlated with liver function indexs levels of pregnant women. AFABP has certain value for predicting the risk of early ICP and evaluating the severity of the disease.