熊去氧胆酸与S-腺苷蛋氨酸治疗妊娠期肝内胆汁淤积症

Effect of ursodeoxycholic acid and S-adenosyl-L-methionine on intrahepatic cholestasis of pregnancy

目的探讨熊去氧胆酸与S-腺苷蛋氨酸联合治疗妊娠期肝内胆汁淤积症(ICP)的疗效及血生化参数变化规律。方法以84例ICP患者为研究对象,给予S-腺甘蛋氨酸静滴1 500 mg/d+熊去氧胆酸250 mg4次/d口服治疗,比较治疗前后的血生化参数。结果治疗后,ICP患者总胆汁酸、甘胆酸、总胆红素、直接胆红素、天门冬氨酸氨基转移酶降低,与治疗前比较,差异有统计学意义(P<0.01)。血浆甘胆酸水平与天门冬氨酸氨基转移酶之间呈低度正相关(r=0.29,P<0.05)。结论 S-腺甘蛋氨酸、熊去氧胆酸治疗ICP疗效良好,血生化参数是对妊娠期肝内胆汁淤积症疗效评价的实用临床指标。

Objective To investigate the effect of ursodeoxycholic acid（UDCA） and S-adenosyl-L-methionine （SAMe） on intrahepatic cholestasis of pregnancy （ICP） , and to observe the change rules of blood biochemical parame- ters during the treatment. Methods 84 hospitalized ICP patients were chosen and given UDCA 250 nag （4 times daily） orally ＋ SAMe 1 500 mg（ once daily）in slow running infusion for 7 d. Blood biochemical parameters were compared. Results The total bile acid, glycocholic acid, total bilirubin, direct bilirubin and aspartate aminotransferase decreased obviously in ICP patients after treatment（ P 〈 0. 01 ）. There was a low positive correlation（ r = 0. 29 ,P 〈 0. 05 ） between glycocholic acid and aspartate aminotransferase. Conclusion The clinical effect of UDCA and SAMe in the treatment of intrahepatic cholestasis of pregnancy is good. The blood biochemical parameters can be used as the practical clinical indexes for the ICP patients.