国际生殖健康/计划生育杂志 ›› 2026, Vol. 45 ›› Issue (2): 172-176.doi: 10.12280/gjszjk.20260025

• 综述 • 上一篇    

妊娠期肝内胆汁淤积症研究进展

方静, 白晓霞()   

  1. 310006 杭州,浙江大学医学院附属妇产科医院产科(方静,白晓霞);浙江省兰溪市人民医院(方静);浙江省生育健康研究中医药重点实验室,浙江省母婴安全研究重点实验室(白晓霞)
  • 收稿日期:2026-01-21 出版日期:2026-03-15 发布日期:2026-04-07
  • 通讯作者: 白晓霞 E-mail:baixiaoxia@zju.edu.cn
  • 基金资助:
    浙江省局省共建中医药重点项目(GZY-ZJ-KJ-23082);金华市重点科技计划项目(2024-3-101)

Research Progress on Intrahepatic Cholestasis of Pregnancy

FANG Jing, BAI Xiao-xia()   

  1. Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China(FANG Jing, BAI Xiao-xia);Lanxi People's Hospital, Lanxi 321102, Zhejiang Province, China (FANG Jing); Zhejiang Provincial Key Laboratory of Reproductive Health Research in Traditional Chinese Medicine, Zhejiang Provincial Key Laboratory of Maternal and Child Health and Safety, Hangzhou 310006, China (BAI Xiao-xia)
  • Received:2026-01-21 Published:2026-03-15 Online:2026-04-07
  • Contact: BAI Xiao-xia E-mail:baixiaoxia@zju.edu.cn

摘要:

妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)是一种妊娠期特发性肝脏疾病,以皮肤瘙痒和血清胆汁酸水平升高为主要特征,可导致不良围产结局甚至胎儿死亡。系统梳理了ICP领域在基因组学、转录组学、蛋白质组学及代谢组学方面的研究进展,揭示了ICP复杂的分子机制和多种新型生物标志物。药物治疗聚焦于现有一线药物熊去氧胆酸的基础上,辅以新药如利福平和中西医结合等治疗。AI驱动的非线性预测模型结合了高危因素、临床和实验室数据,有望为ICP早期预测干预和个体化管理提供强有力的决策工具。多学科强调了从产科学、肝脏病学和营养代谢学角度综合管理ICP的重要性。未来研究应融合人工智能与大数据,构建ICP精准预测模型,探索预防性干预策略,并加强对母儿的长期健康管理,以期改善不良结局。

关键词: 胆汁淤积,肝内, 孕妇, 表观基因组学, 生物标记, 预测模型, 临床管理

Abstract:

Intrahepatic cholestasis of pregnancy (ICP), an idiopathic liver disease in pregnancy, is characterized by pruritus and the elevated level of serum bile acid, which can lead to the adverse perinatal outcomes and even fetal death. This review systematically summarizes the research progress in the genomics, transcriptomics, proteomics, and metabolomics of ICP, revealing its complex molecular mechanisms and various novel biomarkers. Drug therapy of ICP focuses on the existing first-line drug: ursodeoxycholic acid, supplemented by new drugs such as rifampicin and integrated traditional Chinese and Western medicine therapy. The AI-driven nonlinear prediction models, integrating high-risk factors with clinical and laboratory data, may provide powerful decision-making tools for the early prediction, intervention, and personalized management of ICP. Multidisciplinary management emphasizes the importance of comprehensive ICP care from the perspectives of obstetrics, hepatology, and nutritional metabolism. Future research should integrated the artificial intelligence and big data, the construction of accurate prediction models, the preventive intervention strategies and the long-term management of maternal and infant health, so as to improve the adverse perinatal outcomes.

Key words: Cholestasis, intrahepatic, Pregnancy women, Epigenomics, Biomarkers, Predictive model, Clinical Governance