低分子肝素治疗妊娠期肝内胆汁淤积症的疗效及对肝胆指标、母婴结局的影响

Efficacy of Low Molecular Weight Heparin on Intrahepatic Cholestasis of Pregnancy andIts Influence on Hepatobiliary Indexes and Maternal-Infant Outcomes

目的探究低分子肝素治疗妊娠期肝内胆汁淤积症(ICP)的疗效及对肝胆指标、母婴结局的影响。方法选取60例ICP患者为受试对象,随机数字表法分为观察组与对照组各30例。对照组予以常规治疗,观察组在其基础上使用低分子肝素进行治疗。比较两组患者治疗前及治疗21d后的肝胆指标及瘙痒评分变化情况,并记录其母婴结局。结果治疗21d后,两组患者ALT、AST、TBA、TBIL、DBIL水平均较治疗前显著下降(P<0.05),且观察组明显低于同期对照组(P<0.05);治疗21d后,两组患者瘙痒评分较治疗前均有显著下降(P<0.05),且观察组明显低于对照组(P<0.05);治疗21d后,观察组患者早产儿率为10.0%,显著低于对照组的23.3%(P<0.05),且新生儿1min Apgar评分明显高于对照组(P<0.05);而两组患者剖宫产率及低体重儿率比较无统计学意义(P>0.05)。结论低分子肝素可明显改善ICP患者瘙痒症状,提升患者肝胆功能,且对母婴结局有积极影响。

Objective To investigate the efficacy of low molecular weight heparin in the treatment of intrahepatic cholestasis of pregnancy(ICP)and its influence on hepatobiliary indexes and maternal-infant outcomes.Methods 60 patients with ICP were enrolled in the study.They were divided into observation group and control group according to the random number table method,with 30 cases in each group.Control group was given routine treatment while observation group was treated with low molecular weight heparin on this basis.The changes of hepatobiliary indexes and pruritus score before treatment and after 21d of treatment were compared between the two groups,and the maternal-infant outcomes were recorded.Results After 21d of treatment,the levels of ALT,AST,TBA,TBIL and DBIL in the two groups were significantly lower than those before treatment(all P<0.05),and the levels in observation group were significantly lower than those in control group(P<0.05).After 21d of treatment,the pruritus scores in the two groups were significantly lower than those before treatment(all P<0.05),and the score in observation group was significantly lower than that in control group(P<0.05).After 21d of treatment,the premature birth rate in observation group was significantly lower than that in control group(10.0%vs 23.3%)(P<0.05),and the 1min neonatal Apgar score was significantly higher than that in control group(P<0.05).There were no statistically significant differences in the cesarean section rate and low birth weight rate between the two groups(all P>0.05).Conclusion Low molecular weight heparin can significantly improve the symptoms of pruritus and promote the hepatobiliary function of patients with ICP,and it has a positive impact on maternal-infant outcomes.