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妊娠期肝内胆汁淤积症

最后审阅: 12 Nov 2024
最后更新: 18 Oct 2022

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 瘙痒
  • 不伴皮疹的皮肤抓痕
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其他诊断因素

  • 轻度黄疸
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危险因素

  • ICP 家族史
  • ICP 既往史
  • 丙型肝炎感染史
  • 胆石症
  • 慢性乙型肝炎感染
  • 多胎妊娠
  • 辅助生殖技术
  • 种族
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诊断性检查

首要检查

  • 胆汁酸
  • 肝功能检测
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需考虑的检查

  • 凝血指标
  • 丙型肝炎病毒学
  • 肝脏和胆道超声检查
  • 全血细胞计数
  • 自身抗体检测
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治疗流程

急症处理

妊娠期瘙痒(血清胆汁酸浓度 <10 μmol/L)

轻度的妊娠期肝内胆汁淤积症(血清胆汁酸浓度 ≥10 [或非空腹情况下 ≥19] 且 <40 μmol/L)

中度的妊娠期肝内胆汁淤积症(血清胆汁酸浓度 ≥40 且 <100 μmol/L)

重度的妊娠期肝内胆汁淤积症(血清胆汁酸浓度 ≥100 μmol/L)

撰稿人

作者

Catherine Williamson, FRCP, FMedSci

Professor of Women’s Health

King’s College London

Honorary Consultant in Obstetric Medicine

Guy’s and St Thomas’ NHS Foundation Trust

London

UK

利益声明

CW is an author of a number of references cited in this topic. She consults for Mirum Pharmaceuticals and GSK and has been reimbursed for her time given to advise on ileal bile acid inhibitors. She has been a member of two Medical Research Council Boards (Public Health and Systems Medicine Board and Public Health Strategy Board) and is on the Scientific Committee of the Society for Endocrinology. CW has grants from NIHR, Diabetes UK, Lauren Page Trust, and ICP Support.

Caroline Ovadia, BMBCh, MA, PhD, MRCOG

Clinical Senior Lecturer in Obstetrics

King’s College London

Honorary Consultant Obstetrician

Guy’s and St Thomas’ NHS Foundation Trust

London

UK

利益声明

CO is an author of a number of references cited in this topic. She consults for Mirum Pharmaceuticals.

鸣谢

Professor Catherine Williamson and Dr Caroline Ovadia would like to gratefully acknowledge Dr Robert H. Debbs and Dr Derek Jurus, previous contributors to this topic.

利益声明

RHD and DJ declare that they have no competing interests.

同行评议者

Frank Lammert, MD

Director

Department of Internal Medicine II

Professor Internal Medicine

Saarland University Hospital

Homburg

Germany

利益声明

FL declares that he has no competing interests.

Ron Librizzi, DO, FACOOG

Director

Maternal Fetal Medicine

Virtua Health System

Associate Professor of Obstetrics and Gynecology

Thomas Jefferson University School of Medicine

Philadelphia

PA

利益声明

RL declares that he has no competing interests.

Vincenzo Berghella, MD, FACOG

Director

Maternal Fetal Medicine

Professor

Obstetrics and Gynecology

Thomas Jefferson University School of Medicine

Philadelphia

PA

利益声明

VB declares that he has no competing interests.

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