熊去氧胆酸与思美泰治疗妊娠期肝内胆汁瘀积症的疗效观察

目的:观察熊脱氧胆酸(UD-CA)、思美泰(SAMe)治疗妊娠期肝内胆汁淤积症(ICP)的效果。方法:选择60例ICP患者,随机分成二组:A组采用UDCA口服,300mg/次,2次/d;B组采用SAMe1000mg静滴,1次/d;治疗3周或至分娩止,比较二组患者的疗效。结果:治疗后所有患者瘙痒症状改善,两组瘙痒评分差异无显著性意义(P>0.05);治疗后血清T:BA、TB、ALT和AST的水平明显降低(P<0.01),A组的水平较B纽下降明显,差异有显著性意义(P<0.05)。两组妊娠结局差异无显著性意义(P>0.05)。结论:治疗妊娠期肝内胆汁瘀积症,熊去氧胆酸对胆酸及肝功指标的改善较思美泰有效,两种治疗方法均对瘙痒症状改善有效。

Objective to observe the efficacy of ursodeoxychol ic acid （UDCA） , S - ade- nosy - L - methionine （SAMe） in the treatment of intrahepatic cholestasis of pregnancy. Methods： 60 patients were randomly divided into two groups：Group A receiving oral UDCA 300mg,bi/d and group B receiving SAMe 1000mg, q/d. The symptom of itching and serum biochemical indexes, including TBA, TB, ALT, and AST were observed after 3 weeks treatment or deliveried, and the pregnancy outcome between the two groups was compared after delivery. Results： All the patients had a significant improvement in pruritus, There were no significant diferenees among the skin pruritus score in two groups. TBA, ALT, AST and TB had a obvious reduce （ P 〈 0.0 1 ）. It was significantly lower in group A than Group B （ P 〈 0. 05）. The pregnancy outcome between the two groups was similar（ P 〉 0. 05 ）. Conclusions In women with intrahepatic cholestasis of pregnancy, ursodeoxycholic acid is more effective than S - adenosyl - L - methionine at improving the concentration of serum bile acids and other tests of liver function, whereas both therapies are equally effective at improving pruritus.