阿司匹林与熊去氧胆酸治疗妊娠期肝内胆汁淤积症临床分析

Clinical analysis of aspirin and ursodeoxycholic acid on treating intrahepatic cholestasis of pregnancy

目的探讨阿司匹林与熊去氧胆酸治疗妊娠期肝内胆汁淤积症（ICP）的临床效果。方法将71例确诊的ICP患者按随机数字表法分为两组：观察组（36例）给予阿司匹林与熊去氧胆酸治疗，对照组（35例）给予熊去氧胆酸治疗。观察两组生化指标、瘙痒评分及妊娠结局。结果两组治疗后血清总胆汁酸（TBA）、总胆红素（TBIL）、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、瘙痒评分均较治疗前明显下降（P〈0．05）；且观察组治疗后TBA、TBIL、ALT、瘙痒评分[（31．7±8．3）μmol／L、（33．9±5．8）Iμmol/L、（53．1±8．4）U／L、（0．48±0．06）分]显著低于对照组[（76．2±9．2）μmol／L、（56．9±8．2）μmol／L、（80．8±10．6）U／L、（0．81±0．04）分]（P〈0．05）。观察组羊水污染、早产、新生儿窒息发生率均明显低于对照组[38．9％（14／36）比71．4％（25／35）、11．1％（4／36）比31．4％（11／35）、5．6％（2／36）比22．9％（8／35），P〈0．05]。结论熊去氧胆酸与阿司匹林联合应用可改善ICP患者的生化指标、皮肤瘙痒症状和妊娠结局。

Objective To investigate the clinical effect of aspirin and ursodeoxycholic acid on treating intrahepatic cholestasis of pregnancy （ICP）. Methods Seventy-one ICP patients were divided by random digits table method into observation group （36 cases） and control group （35 cases）. Observation group was treated with aspirin and ursodeoxycholic acid. Control group was given ursodeoxycholic acid. The biochemical indicators, itching score and pregnancy outcomes of two groups were observed. Results Total bile acid （TBA）,total bilirubin （TBIL）,alanine aminotransferase （ALT）,aspartate aminotransferase （AST） and itching score of two groups after treatment were all significantly lower than those before treatment （P 〈 0.05 ）. TBA, TBIL, ALT and itching score of observation group[ （ 31.7 ± 8.3 ） μ tool/L, （33.9 ± 5.8 ）μ mol/L, （53.1 ± 8.4） U/L, （0.48 ± 0.06） scores] were obviously lower than those of control group [ （76.2 ± 9.2） μ mol/L, （56.9 ± 8.2） μ mol/L, （80.8 ± 10.6） U/L, （0.81 ± 0.04） scores] （P 〈 0.05）. The incidences of amniotic fluid contamination,premature delivery and neonatal asphyxia of observation group were significantly lower than those of control group [ 38.9%（14/36） vs. 71.4%（25/35）, 11.1% （4/36） vs. 31.4% （ 11/35 ）, 5.6% （2/36） vs. 22.9% （ 8/35 ）, P 〈 0.05 ]. Conclusions The combined application of aspirin and ursodeoxycholic acid can improve the biochemical indicators, itching symptom and pregnancy outcomes.