熊去氧胆酸联合S-腺苷蛋氨酸治疗妊娠期轻度肝内胆汁淤积症的疗效观察

发布时间：2019-06-15 07:15

【摘要】：目的:观察熊去氧胆酸(UDCA)联合S-腺苷蛋氨酸(SAMe)治疗妊娠期轻度肝内胆汁淤积症(ICP)的疗效。方法:选取妊娠期轻度ICP患者213例,按随机数字表法分为联合组(107例)和单药组(106例)。联合组患者采用UDCA联合SAMe治疗,单药组采用UDCA治疗,比较两组患者的疗效及妊娠结局差异。结果:治疗后两组患者的总胆汁酸、肝胆酸、直接胆红素、丙氨酸转氨酶、天冬氨酸转氨酶检测值较治疗前均降低,联合组降低较单药组更加显著,差异均有统计学意义(P0.05);联合组患者的瘙痒控制时间[(3.8±1.4)d]短于单药组[(5.3±1.5)d],差异有统计学意义(P0.05);治疗后第3、5天联合组患者的瘙痒程度评分低于单药组患者,差异具有统计学意义(P0.05);联合组与单药组的胎儿窘迫发生率、新生儿窒息发生率、羊水污染率、剖宫产率、新生儿1 min Apgar评分比较,差异均无统计学意义(P0.05);联合组患者的早产率为11.22%,显著低于单药组的20.75%,差异具有统计学意义(P0.05)。结论:UDCA联合SAMe治疗ICP患者较单用UDCA治疗能够更及时地控制患者的临床症状,尽快恢复实验室指标,取得更好的疗效。
[Abstract]:Aim: to observe the efficacy of ursodeoxycholic acid (UDCA) combined with S-adenosine methionine (SAMe) in the treatment of mild intrahepatic cholestasis of pregnancy (ICP). Methods: 213 patients with mild ICP during pregnancy were randomly divided into combined group (n = 107) and single drug group (n = 106). The patients in the combined group were treated with UDCA combined with SAMe, and the patients in the single drug group were treated with UDCA. The curative effect and pregnancy outcome of the two groups were compared. Results: after treatment, the detection values of total bile acid, hepatocholic acid, direct bilirubin, alanine transaminase and aspartate transaminase in the combined group were significantly lower than those in the single drug group (P 0.05), and the itching control time in the combined group [(3.8 卤1.4) d] was shorter than that in the single drug group [(5.3 卤1.5) d], and the difference was statistically significant (P 0.05). On the 3rd and 5th day after treatment, the score of pruritus in the combined group was significantly lower than that in the single drug group (P 0.05), and there was no significant difference in the incidence of fetal distress, neonatal asphyxia, amniotic fluid contamination rate, cesarean section rate and neonatal 1 min Apgar score between the combined group and the single drug group (P 0.05). The premature delivery rate of the combined group was 11.22%, which was significantly lower than that of the single drug group (20.75%) (P 0.05). Conclusion: UDCA combined with SAMe can control the clinical symptoms of ICP patients more timely than UDCA alone, recover the laboratory indexes as soon as possible, and obtain better curative effect.
【作者单位】：无锡市妇幼保健院;
【分类号】：R714.25

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