熊去氧胆酸、腺苷蛋氨酸联合多烯磷脂酰胆碱对妊娠期肝内胆汁淤积症患者相关指标的影响

发布时间：2018-10-18 19:18

【摘要】：目的:探讨熊去氧胆酸、腺苷蛋氨酸联合多烯磷脂酰胆碱对妊娠期肝内胆汁淤积症(ICP)患者相关指标的影响。方法:回顾性分析90例ICP患者资料,按用药的不同分为对照组(45例)和观察组(45例)。对照组患者给予熊去氧胆酸片300 mg,口服,每日3次+注射用丁二磺酸腺苷蛋氨酸1 g,加入5%葡萄糖注射液250 m L中,静脉滴注,每日1次。观察组患者在对照组治疗的基础上给予多烯磷脂酰胆碱注射液15 m L,加入5%葡萄糖注射液250 m L中,静脉滴注,每日1次。两组疗程均为2周。观察两组患者治疗前后瘙痒评分、血清胆汁酸(TBA)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)水平,妊娠结局及不良反应发生情况。结果:治疗前,两组患者瘙痒评分和TBA、ALT、AST水平比较,差异均无统计学意义(P0.05)。治疗后,两组患者瘙痒评分和TBA、ALT、AST水平均显著低于同组治疗前,且观察组显著低于对照组,差异均有统计学意义(P0.05)。观察组患者剖宫产、早产、胎儿窘迫和羊水粪染发生率均显著低于对照组,差异均有统计学意义(P0.05)。两组患者治疗期间均未见明显不良反应发生。结论:熊去氧胆酸、腺苷蛋氨酸联合多烯磷脂酰胆碱可有效改善ICP患者的瘙痒症状、肝功能及妊娠结局,且安全性较好。
[Abstract]:Aim: to investigate the effects of ursodeoxycholic acid, adenosylmethionine and polyenylphosphatidylcholine on (ICP) patients with intrahepatic cholestasis of pregnancy. Methods: the data of 90 patients with ICP were analyzed retrospectively and divided into control group (45 cases) and observation group (45 cases). The control group was given ursodeoxycholic acid tablets orally for 300 mg, 1 g of adenosylmethionine butyrate was injected three times a day, added 5% glucose injection 250ml, intravenous drip, once a day. The patients in the observation group were given polyenylphosphatidylcholine injection 15 mL on the basis of treatment in the control group, added 5% glucose injection 250 mL, intravenous drip, once a day. The course of treatment was 2 weeks in both groups. The pruritus score, serum bile acid (TBA), alanine aminotransferase (ALT),) aspartate transaminase (ALT),) (AST), pregnancy outcome and adverse reactions were observed before and after treatment. Results: before treatment, there was no significant difference in pruritus score and TBA,ALT,AST level between the two groups (P0.05). After treatment, the pruritus score and TBA,ALT,AST level of the two groups were significantly lower than those of the same group before treatment, and the observation group was significantly lower than the control group, the difference was statistically significant (P0.05). The incidence of cesarean section premature delivery fetal distress and amniotic fluid feces in the observation group were significantly lower than those in the control group (P0.05). No significant adverse reactions occurred during treatment in both groups. Conclusion: ursodeoxycholic acid, adenosylmethionine and polyenylphosphatidylcholine can effectively improve the pruritus, liver function and pregnancy outcome of ICP patients, and the safety is good.
【作者单位】：重庆医科大学附属大学城医院妇产科;
【分类号】：R714.255

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