Value of the combined use of aminotransferase-to-platelet ratio index and total bile acid for predicting parenteral nutrition-associated cholestasis in preterm infants with gestational age <34 weeks / 中国当代儿科杂志

OBJECTIVES@#To explore the value of the combined use of aspartate aminotransferase-to-platelet ratio index (APRI) and total bile acid (TBA) for predicting parenteral nutrition-associated cholestasis (PNAC) in preterm infants with gestational age <34 weeks.@*METHODS@#A retrospective analysis was performed on medical data of 270 preterm infants born at <34 weeks of gestation who received parenteral nutrition (PN) during hospitalization in the First Affiliated Hospital of Wannan Medical College from January 2019 to September 2022, including 128 infants with PNAC and 142 infants without PNAC. The medical data between the two groups were compared, and predictive factors for the development of PNAC were explored through multivariate logistic regression analysis. The receiver operating characteristic (ROC) curve was used to evaluate the value of APRI alone, TBA alone, and the combination of both for predicting PNAC.@*RESULTS@#TBA levels in the PNAC group after 1, 2, and 3 weeks of PN were higher than those in the non-PNAC group (P<0.05). APRI in the PNAC group after 2 and 3 weeks of PN was higher than that in the non-PNAC group (P<0.05). Multivariate logistic regression analysis showed that elevated APRI and TBA after 2 weeks of PN were predictive factors for PNAC in preterm infants (P<0.05). ROC curve analysis showed that the sensitivity, specificity, and area under the curve (AUC) for predicting PNAC by combining APRI and TBA after 2 weeks of PN were 0.703, 0.803, and 0.806, respectively. The AUC for predicting PNAC by combining APRI and TBA was higher than that of APRI or TBA alone (P<0.05).@*CONCLUSIONS@#After 2 weeks of PN, the value of combining APRI and TBA for predicting PNAC is high in preterm infants with gestational age <34 weeks.

Pregnancy outcome in patients with intrahepatic cholestasis of pregnancy: an observational case control study

Background: Intrahepatic cholestasis of pregnancy (IHCP) is the most common cholestatic liver disease, which may impact the foeto-maternal health. The present study is conducted to determine various factors including maternal and neonatal outcome in IHCP comparing with the controls.Methods: In this prospective case control study, pregnancy with IHCP is compared with asymptomatic non-IHCP controls. Classical pruritus, icterus, elevated liver enzymes were considered in diagnostic criteria of IHCP. Dermatological lesion, acute or chronic liver disease, and other causes of pruritus were excluded from study.Results: Out of 100 patients, 50 cases and 50 controls were included in this study. Incidence of IHCP was seen 3.914% of which 66% were primi presented maximum at 31-33 weeks. 86% of IHCP responded to medication. Mean value of ALT, AST and ALP was found significantly raised (p value-<0.001) in IHCP patients. 66% in IHCP and 64% in non-IHCP group had normal delivery and remaining 34% and 36 % had caesarean delivery respectively. There was no significant increase in foetal distress or low Apgar (<7 at 5 min) at birth or adverse neonatal or maternal outcome in IHCP group. However, there was a statistically high meconium stained liquor (MSL), neonatal jaundice, IUGR and NICU admission were noted in the IHCP group in comparison to non-IHCP group.Conclusions: There is a significant incidence of IHCP in the obstetrical population. The biochemical changes, meconium stained liquor, neonatal jaundice, IUGR and NICU admission were significantly high in IHCP in pregnancy.

Identification of Matrix Metalloproteinase-2 and 9 as Biomarker of Intrahepatic Cholestasis of Pregnancy

ABSTRACT Intrahepatic cholestasis of pregnancy (ICP) is a severe liver disease uniquely occurring during pregnancy. In this study we aimed to identify novel biomarker for the diagnosis of ICP in Chinese population. 50 healthy pregnant women, 50 mild ICP patients and 48 severe ICP patients were enrolled for this study. Liver function tests, including serum total bilirubin, direct bilirubin, alanine transaminase, aspartate aminotransferase and cholyglycine, were performed in all participants. After an overnight fast serum levels of total bile acids (TBA), matrix metalloproteinase (MMP)-2 and MMP-9 were measured, and their correlation with liver function tests were analyzed. The observed increase in serum TBA in ICP patients was not statistically significant which made it unreliable for diagnosis of ICP in Chinese population. On the other hand, both MMP-2 and MMP-9 serum levels exhibited a progressive and significant elevation in mild and severe ICP patients compared with healthy pregnant women, which also positively correlated with liver function tests. Serum levels of both MMP-2 and MMP-9 could be reliably used as laboratory abnormalities for accurate diagnosis and sensitive grading of ICP in Chinese population.

Clinical Significance of Detecting Serum TBA and CG in Early Diagnosis of Intrahepatic Cholestasis of Pregnancy and Perinatal Adverse Outcomes Influence / 现代检验医学杂志

Objective To investigate the clinical significance of serum total bile acid(TBA)and cholyglycine(CG)detection in the early diagnosis of intrahepatic cholestasis of pregnancy(ICP)and perinatal adverse outcomes.Methods Chose 67 ca-ses of ICP pregnant women diagnosed and treated in Chang'an Hospital from June 2015 to June 2017 and they were selected as observation group.According to the 2015 edition of the diagnostic guidelines for the diagnosis and treatment of intrahe-patic cholestasis of pregnancy.The patients were divided into mild ICP group and severe ICP group,and 60 healthy pregnant women were selected as the control group.The serum TBA concentration was measured by fifth generation cyclic enzyme method and the concentration of serum CG was detected by latex enhanced turbidimetric immunoassay.The serum TBA,CG test results and the rate of abnormal test results,the incidence rate of perinatal adverse outcomes were compared between groups.Evaluation of serum TBA and CG detection of pregnancy early diagnosis of intrahepatic cholestasis and clinical value of perinatal adverse outcomes.Results The detection results of serum TBA and CG in the control group,mild ICP group and severe ICP group,there were significant differences between the three groups,the difference was statistically significant (P<0.01),the detection results in the CG group,serum TBA,ICP slightly higher than the control group,the difference was statistically significant(t=22.27,39.68,P<0.05).Weight of serum TBA and ICP group,the results of CG was higher than that of patients with mild ICP group,the difference was statistically significant(t=10.24,70.87,P<0.05).And in the con-trol group,mild ICP group,severe ICP group pregnant women serum TBA,CG test results increased with the aggravation of the disease.Serum TBA and CG abnormal results in 60 cases of the control group were not detected.In 67 cases of group ICP(mild ICP group and severe ICP group)were 63 cases and 61 cases,two groups of abnormal results rate comparison,and the difference was statistically significant(χ2=29.35,31.27,P<0.01).Perinatal premature labor,fetal distress,perinatal death and stillbirth incidence of adverse perinatal outcomes in the control group,mild ICP group and severe ICP group were significantly different between the three groups(χ2=39.17,56.31,13.02,6.92,P<0.01).Conclusion Intrahepatic chole-stasis of pregnancy,serum TBA and CG increased significantly,can be used as a sensitive indicator of ICP diagnosis,improve the detection rate of ICP,and effectively predict perinatal outcome.For intrahepatic cholestasis of pregnancy early detection and early diagnosis,it has important clinical significance.

The analysis of interference factors and solutions to the cross contaminationbetween total bile acid and 30 inspection items on the Roche biochenical analyer / 国际检验医学杂志

Objective To explore the interference factors of total bile acid project and 30 routine items on the Roche Modular P800 automatic biochemical analyzer,and to find the effective measures to eliminate the carry-over.Methods In accordance with the screening process,the interference factors of total bile acid project as the test item,30 regular testing projects as the observation objects,including total bilirubin,direct bilirubin and so on,and then the validation test were carried out.By means of the increasing cleaning procedures of the reagent needles or colorimetric cups and adjusting the test sequence,we compared the influence of the result of total bile acid before and after this kind of treatment.Results There were the carry-over of high density lipoprotein,uric acid and total bile acid,which could be eliminated by increasing cleaning procedures of reagent needles or colorimetric cups.There were the cross contamination of lipase and total bile acid,which could be basically eliminated by adjusting the test sequence.Conclusion There are the cross contamination among the various projects of automatic biochemical analyzer.To avoid this carry-over,we should pay attention to the order of the infectant and contaminated items in setting the analysis parameters,insert several projects in the interval,or add the cleaning procedures of the reagent needles or colorimetric cups with alkali or acid.

Study on maternal serum total bile acids in intrahepatic cholestasis of pregnancy on neonatal lung injury / 重庆医学

Objective To explore the correlation between maternal serum total bile acid (TBA) of pregnant women with intrahepatic cholestasis of pregnancy (ICP) and varying degrees of neonatal lung injury.Methods A total of 52 cases of pregnant women with ICP and their corresponding newborns were enrolled into the ICP group from March 2014 to December 2015 in the People's Hospital of Shapingba District.Other 52 cases of pregnant women received cesarean delivery whose gestational age and birth weight of newborns were close to the ICP group and their corresponding newborns were selected as the control group.The conditions of neonatal lung injury were recorded,and the correlations of maternal serum level of TBA and exposure time of high serum level of TBA to degrees of lung injury were analyzed as well.Results The incidence rate of neonatal lung injury in the ICP group (67.3 ％) was higher than that in the control group (17.3 ％),there was statistically significant difference (P＜0.05).The degree of lung injury was positively correlated with maternal serum level of TBA and exposure time of high serum level of TBA (r=0.687,P=0.000;r=0.523,P=0.001).Conclusion The probability of neonatal lung injury of corresponding pregnant women with ICP is significantly increased,and the extent of lung injury is positively correlated with concentration of maternal serum TBA and exposure time of high serum level of TBA.

Value of αL-fucosidase and its correlation with total bile acids in pregnant women with gestational diabetes mellitus / 实用医学杂志

Objective To observe the detection value of α-L-fucosidase (AFU) in gestational diabetes mellitus (GDM) and the correlation of AFU with total bile acids (TBA).Methods Anthropometric parameters and serum biochemical indexes were recorded and 75 g OGTT was performed then according to OGTT result,patients with GDM were confirmed and matched the control group by age and BMI.Results The level of AFU in GDM group was higher than that that of normal glucose tolerance (NGT) group and associated with 1 hour postprandial glucose.After correcting ALT and HbA1c,AFU correlated with TBA.Conclusions During pregnancy,AFU has reference value for the diagnosis of GDM and 1 hour postprandial glucose is its independent factor.The rise AFU is combined with the decrease of.DBIL but the increase of TBA and ALP,which indicates bile duct system in patients with GDM is in an active state.

Clinical significance of joint detection with cholyglycine and total bile acid intrahepafic cholestasis during pregnancy / 国际检验医学杂志

Objective To research the significance of detection of cholyglycine(CG) and total bile acid (TBA ) in intrahepatic cholestasis of pregnancy(ICP) .Methods Totally 85 gestational patients of ICP and 85 normal pregnancy pregnant women(control group) were chosen .Indexes including CG ,TBA ,ALT ,AST and TBIL were detected ,and the results were compared .Results In ICP group ,the levels of serum CG ,TBA ,ALT ,AST and TBIL were significantly higher than those in the normal control group ,and the differences were statistically significant(P< 0 .05) ;The positive rates of serum CG and TBA in ICP were significant higher than those in control group(P< 0 .05) .Conclusion The level of CG and TBA in intrahepatie cholestasis of pregnancy are significantly increased and might be sensitive indicators of gestaional diabetes in intrahepatie cholestasis of pregnancy ,the joint detection is of great clinical significance for ICP early diagnosis and monitoring .

Effect of ursodeoxycholic acid on intrahepatic cholestasis and total bile acid etc.in umbilical venous of pregnancy / 中国生化药物杂志

Objective To explore the curative effect of ursodeoxycholic acid in treatment of intrahepatic cholestasis of pregnancy (ICP) and the effect on total bile acid (TBA) in post partum fetal umbilical venous blood .Methods 30 patients with intrahepatic cholestasis of pregnancy who were admitted into the Hospital Affiliated to Sichuan Medical University during January 2014 to December 2014 were selected as the research objects and randomly divided into observation group and control group ,15 cases in each group.The observation group were given ursodeoxycholic acid tablets while control group were injected with ademetionine butanedisulfonate .The curative effect of two kinds of drugs in treatment of intrahepatic cholestasis of pregnancy was observed and the effect on total bile acid in post partum fetal umbilical venous blood was analyzed .ResuIts After treatment , the TBA and ALT of observation group were significantly lower than those pre-treatment and those of control group (P<0.05).There were no significant differences of TBIL and ALP between two groups and within groups.TBA and TBIL in post partum fetal umbilical venous blood of observation group were significantly lower than those of control group (P<0.05).There was no significant difference of ALT level between two groups .There were two cases of abnormal perinatal outcomes in observation group while seven cases in control group (χ2 =3.97, P<0.05).ConcIusion Ursodeoxycholic acid could effectively reduce the total bile acid levels in maternal and fetal umbilical vein blood, reduce the mortality rate of the fetal and improve the perinatal outcomes , with high security.

Research on expression of TNF-α in intrahepatic cholestasis of pregnancy / 重庆医学

Objective To investigate the influence of total bile acid (TBA) ,cholyglycine(CG) ,biochemical parameters of liv‐er ,tumor necrosis factor‐α(TNF‐α) in the patients of intrahepatic cholestasis of pregnancy (ICP) on parturients and perinatal new‐borns .Methods The clinical data in 164 cases of ICP in our hospital from January 2012 to December 2013 were retrospectively ana‐lyzed .TBA ,CG and TNF‐αwere detected by the radioimmunoassay and TBIL ,DBIL ,ALT and AST were analyzed by the biochemi‐cal analyzer .Results TBA ,CG ,TBIL ,DBIL and ALT in the patients with ICP were increased than those in normal pregnant women ,i .e .the liver function was damaged ,serum TNF‐αexpression was increased ,the above indexes in the patients with severe ICP were increased compared with the mild ICP patients ,postpartum hemorrhage volume was increased and the Apgar scores were decreased (P<0 .05) .Conclusion ICP is high risk pregnancy .TNF‐α,CG and TBA reflect the severity degree of ICP .

Value of bile acid,CEA,CA199,CA72-4 detection in the diagnosis of gastric carcinoma / 国际检验医学杂志

Objective To evaluate the value of diagnosis of total bile acid (TBA ) ,CEA ,CA199 ,CA72‐4 in gastric carcinoma combined detection .Methods From 2013 January to 2014 April in hospital of each stage of gastric cancer in 53 patients ,80 patients in benign gastric disease group and healthy group of 120 people ,were detected the concentration of TBA ,CEA ,CA199 respectively , the serum CA72‐4 .Results Three testing groups ,detecting indexes in patients with gastric cancer group were TBA (59 .55 ± 20 . 56)μmmol/L ,CEA (17 .26 ± 11 .69)g/L ,CA199 (82 .08 ± 6 .9)U/mL ,CA72‐4 (68 .65 ± 23 .05)U/mL ,concentrations were higher than the other two groups ,with statistically significant difference between groups (P0 .05) .Conclusion TBA ,CEA ,CA199 ,CA72‐4 index can be used as the detection index of clinical judgment of gastric tumor ,with a high clinical value of combined detection indexes of gastric cancer clinical treatment and prognosis .

The expression and diagnostic significance of phosphatidylinositol 3 proteoglycans and alpha-fetoprotein heterogeneity and total bile acids in primary hepatocellular carcinoma / 中国医师进修杂志

Objective To evaluate the clinical significance of combined detection of phosphatidyhnositol 3 proteoglycans (GPC3) and alpha-fetoprotein heterogeneity (AFP-L3) and total bile acids (TBA) in diagnosis of primary hepatocellular carcinoma.Methods Collected 154 cases of primary hepatocellular carcinoma patients (hepatocellular carcinoma group) and 78 cases of cirrhosis patients (cirrhosis group) and 56 normal controls (control group) from May 2011 to December 2012.The level of GPC3,AFP-L3 was measured by enzyme-linked immunosorbent assay,the level of alpha-fetoprotein (AFP) was determined by mdioimmunoassay,and the level of TBA was measured by enzymatic cycle,and they were compared.Results The level of GPC3,AFP-L3 and TBA was (10.70 ± 3.10) μ g/L,(338.60 ± 379.20) μ g/L,(79.91 ± 70.64) μ mol/L in hepatocellular carcinoma group,which was higher than that in cirrhosis group [(2.70 ±0.71) μg/L,(6.45 ±2.79) μg/L,(33.10 ±21.90) μmol/L] and control group [(1.28 ± 0.60) μ g/L,(0.68 ± 0.56) μ g/L,(5.40 ± 2.20) μ mol/L],the level of GPC3,AFP-L3 and TBA in cirrhosis group was higher than that in control group,and there was significant difference (P＜ 0.01).The sensitivity of three tumor markers combined detection was 97.2％ (280/288),which was significantly higher than that of individual detection of GPC3 (72.1％,111/154),AFP-L3 (53.2％,82/154),TBA (94.8％,146/154),the difference was statistically significant (P ＜ 0.01).Conclusion Serum GPC3,AFP-L3 and TBA combined detection can improve the sensitivity of primary hepatocellular carcinoma and has important chnical significance in early diagnosis of primary hepatocellular carcinoma.

Observation on the total bile acid in the blood serum in neonatal hyperbilirubinemia / 中国基层医药

Objective To investigate the change of the bile acid in the blood serum and its significance in the neonates with hyperbilirubinemia.Methods The levels of total bile acid (TBA),the cytomegalovirus IGM and the liver function including the AST,the ALT and the GGT were detected in 298 neonates with hyperbilirubinemia.The neonates were divided into two groups by the levels of total bilirubin in the blood serum the light-degree and severedegree group,and which need to compare with the control group consisting of 29 neonates.Results There were 254neonates in the light-degree group and 44 in the severe-degree group.Making comparison of the average value including AST,ALT,GGT,TBA and the positive rate,it showed that there was no statistical significance between the two groups (P ＞ 0.05).The GGT and TBA in both the light-and severe-degree group were higher than the control group,the difference had statistical significance(P ＜0.01).Testing the CMV-IgM of 214 neonates with hyperbilirubinemia,it showed that the results were all normal.Conclusion Most neonates with hyperbilirubinemia suffer from liver parenchyma injury and cholestasis,also the levels of TBA in the blood serum have no concern with the degree of jaundice.So the liver protection drugs can be properly used in the treatment.The TBA is more sensitive than the ALT to diagnose the liver parenchyma injury in neonates with hyperbilirubinemia.

Significance of Serum Total Bile Acid and Cholinesterase in Diagnosis and Treatment of Infantile Hepatopathy / 实用儿科临床杂志

Objective To explore clinical value of serum total bile acid(TBA) and cholinesterase(CHE) in infantile hepatopathy.Methods Sixty infants diagnosed respectively with breast milk jaundice,cytomegalovirus hepatitis and congenital bile duct teratism were included.Twenty healthy infants were as control.The infants of cytomegalovirus hepatitis were self-compared in acute stage and convalescence stage.Serum TBA and CHE in every group were measured and compared.Results Serum TBA in control group,breast milk jaundice group,cytomegalovirus hepatitis group and congenital bile duct teratism group were(6.47?3.25),(8.71?1.79),(45.86?40.85),(119.50?31.73) ?mol/L,respectively;and CHE were(11295.50?1731.91),(10762.89?1237.30),(9771.32?860.27),(7967.304?31.58) U/L,respectively.Compared with other groups,the level of serum TBA and CHE in cytomegalovirus hepatitis group and the congenital bile duct teratism group were significantly different(all P

The Influence and Preventive Measures for theTest Results of Total Bile Acid about Blood Lipid Testing Reagent / 医学研究杂志

Objective To study The influence and preventive measures for the test results of total bile acid about blood Lipid testing reagent. Methods In Mindray BS -300 automatic biochemical analyzer, we detected total bile acid of the fresh mixed serum separately, then we tested the same samples after the test items of cholesterol, triglycerides, high -density lipoprotein, low - density lipoprotein. Then using fresh serum mixed with normal saline and blood lipid reagent according to 1: 1 dilution ,we measured TBA. We did cross - contamination corrected test (by the anti - cross - contamination to repeat the first step after the test) and recorded all results and had statistics analysis. Results This experiment found that reagents Ⅰ of TC, TG and the reagent Ⅱ of HDL - C , LDL - C had significant positive interference in determination of TBA results. After being corrected by anti - cross - contamination, the results returned to normal. Conclusion When using the automatic biochemical analyzer, we not only acquired the worker fououed of the equipment, and reagents, determined principle, but also pay attention to cross - contamination among reagents, and then in accordance with the equipment work characteristics to establish the appropriate measures to eliminate them, so made sure the reliability of the experimental data to provide clinic with the true objective and actual diagnosis evidence fundamentally.

Study About the Relationship Between the Level of Serum Total Bile Acid and Fetal Distress of Intrahepatic Cholestasis Pregnancy / 医学研究杂志

Objective To study the relationship between the level of serum total bile acid(TBA)and fetal distress of intrahepatic cholestasis pregnancy(ICP).Methods 357 patients with ICP were devided into two groups,fetal distress group and non-fetal distress group.Their levels of TBA were collected retrospectively.Results The incidence rates of fetal distress rose with the increasing level of TBA.As the level of TBA was over 35umou/L,the incidence rates of fetal distress rose significantly.Conclusion The study suggest that the level of TBA maybe one of sensitive marker to preditect fetal distress.

Changes of the concentration of serum total bile acid in essential hypertension / 中国综合临床

Objective To investigate the role of total bile acid (TBA) in pathogenesis of essential hypertension.Methods The concentration of serum TBA was measured by enzymatic method in 127 cases including 30 healthy controls,21 secondary hypertensive patients and 76 essential hypertensive patients.Results There was a significant increase of TBA in essential hypertensive group compared with that of control group and secondary hypertension (P 0.05) .In essential hypertensive group,the levels of TBA in grade 3 hypertension were higher than that of grade 1 hypertension (P0.05).Conclusion The abnormal increasing of TBA may play a role in pathogenesis of essential hypertension.

Relationship between the concentration of fetal total bile acid and fetal adrenocortical dysfunction in intrahepatic cholestasis of pregnancy / 中华围产医学杂志

Objective To evaluate the association of fetal total bile acid (TBA) concentration with fetal adrenocortical dysfunction in intrahepatic cholestasis of pregnancy(ICP). Methods The concentration of TBA, cortisol and DHEA-S in the cord blood were measured in 20 fetuses with maternal ICP (ICP group) and 22 fetuses of normogravidas (control group) after elective cesarean section. The cord blood TBA concentration was investigated by enzyme method and the cord concentration of cortisol and DHEA-S by radioimmunoassay. Results The cord TBA concentration in ICP group was significantly higher than that of controls [(8.93?3.16)mmol/L vs (4.33?1.51)mmol/L, P0.05)]. The cord blood level of cortisol,DHEA-S and the ratio of DHEA-S over cortisol were correlated with the cord blood TBA concentration (r 1= 0.87,r 2=-0.88,r 3=-0.84,P