多烯磷脂酰胆碱联合丁二磺酸腺苷蛋氨酸治疗HBV感染合并ICP的效果

Effect of polyene phosphatidylcholine combined with smetel in the treatment of HBV complicated with ICP

目的探讨多烯磷脂酰胆碱联合丁二磺酸腺苷蛋氨酸治疗乙型肝炎病毒(HBV)感染合并妊娠期肝内胆汁淤积症(ICP)的效果及对鸢尾素、甘胆酸的作用。方法选择2018年1月-2021年1月在如皋市人民医院治疗的77例HBV感染合并ICP患者,采用随机数表法分为试验组(n=39)和对照组(n=38)。对照组给予丁二磺酸腺苷蛋氨酸治疗,试验组在对照组的基础上给予多烯磷脂酰胆碱治疗。比较两组临床疗效,血清鸢尾素、甘胆酸、天门冬氨酸氨基转移酶(AST)、谷氨酸氨基转移酶(ALT)、总胆红素(TBIL)水平及临床症状消失时间,以及妊娠结局。结果试验组总有效率明显高于对照组(92.31%vs.73.68%),差异有统计学意义(χ^(2)=4.757,P=0.029)。治疗后,试验组和对照组血清鸢尾素、甘胆酸水平均下降,且试验组低于对照组,差异有统计学意义(t=2.384、4.941,P均<0.05)。治疗后,试验组和对照组AST、ALT及TBIL水平均下降,且试验组低于对照组,差异有统计学意义(t=10.087、4.239、58.184,P均<0.05)。试验组临床症状改善时间均显著早于对照组,差异有统计学意义(P<0.05)。试验组不良妊娠结局发生率均显著低于对照组,差异有统计学意义(P<0.05)。结论HBV感染合并ICP患者应用多烯磷脂酰胆碱联合丁二磺酸腺苷蛋氨酸治疗效果显著,可有效改善患者血清鸢尾素、甘胆酸水平。

Objective To study effect of polyene phosphatidylcholine combined with smetel in the treatment of hepatitis B virus(HBV)complicated with intrahepatic cholestasis of pregnancy(ICP),and on irisin and glycocholic acid.Methods A total of 77 patients with chronic hepatitis B complicated with intrahepatic cholestasis during pregnancy who were treated in our hospital from January 2018 to January 2021 were selected and divided into experimental group(n=39)and control group(n=38)by random number table method.The control group was given simetai treatment;the experimental group was given polyene phosphatidylcholine treatment based on the control group.The clinical efficacy,changes of serum irisin,glycocholic acid,aspartate aminotransferase(AST),alanine aminotransferase(ALT),total bilirubin(TBIL),clinical symptoms and pregnancy outcomes were compared between the two groups.Results After treatment,the total effective rate between the two groups was significantly different(χ^(2)=4.757,P=0.029).After treatment,serum irisin and glycocholic acid levels in experimental group and control group decreased over time,and the experimental group was lower than the control group,the difference was statistically significant(t=2.384,4.941,all P<0.05).After treatment,AST,ALT and TBIL levels in experimental group and control group decreased with time,and the experimental group was lower than the control group,the difference was statistically significant(t=10.087,4.239,58.184,all P<0.05).The improvement time of clinical symptoms in experimental group was significantly lower than that in control group(P<0.05).The incidence of adverse pregnancy outcomes in experimental group was significantly lower than that of the control group(P<0.05).Conclusion Polyene phosphatidylcholine combined with sumetine had a significant treatment effect on pregnant women with intrahepatic cholestasis,which could effectively improve the levels of serum irisin and glycocholic acid.