妊娠期肝内胆汁淤积症78例临床治疗分析

Clinical treatment analysis of 78 patients with intrahepatic cholestasis of pregnancy

目的观察思美泰(丁二磺酸腺苷蛋氨酸)和优思弗(熊去氧胆酸)联合用药与思美泰单用治疗妊娠期肝内胆汁淤积症(ICP)的疗效。方法选取2010年1月至2013年1月收治的78例ICP患者,分成对照组和治疗组各39例。对照组给予思美泰治疗,治疗组给予思美泰联合优思弗治疗,14 d为1个疗程。对两组患者瘙痒症状改善情况、孕周、肝功能指标的改善进行比较。结果两组患者治疗后皮肤瘙痒情况明显好转,与治疗前比较,差异有统计学意义(P<0.05);治疗组治疗后较对照组评分低,差异有统计学意义(P<0.05);治疗组治疗后孕周[(36.3±0.11)周]较对照组[(34.2±0.17)周]明显延长,差异有统计学意义(P<0.05);两组患者治疗后总胆红素(TBIL)、胆汁酸(TBA)、丙氨酸氨基转移酶(ALT)水平均有所下降,与治疗前比较,差异有统计学意义(P<0.05);且治疗组治疗后TBIL、TBA、ALT水平较对照组下降更明显,差异有统计学意义(P<0.05)。结论思美泰和优思弗联合用药治疗ICP较单用思美泰疗效更显著。

Objective To observe the efficacy of Transmetil（ademetionine1,4-butanedisulfonate for injection） combined with ursodeoxycholic acid （UDCA） and Transmetil alone in the treatment of intrahepatic cholestasis of pregnancy （ICP）. Meth-ods Totally 78 ICP patients,who were enrolled in the hospital from January 2010 to January 2013 ,were selected and random-ized into control group and treatment group with 39 cases in each group. The control group was given Transmetil for treatment , while the treatment group was with Transmetil combined with ursodeoxycholic acid for treatment ,14 days as a course. The im-provement of symptoms with itching,gestational weeks and improvement of liver function in both groups were compared. Results The itching in both groups improved obviously after treatment,and compared with before treatment,the difference had statisti-cally significant difference（P＆lt;0.05）. The score after treatment in the treatment group was lower than that in the control group with statistically significant difference（P＆lt;0.05）. The gestational weeks after treatment in the treatment group[（36.3＆#177;0.11）weeks] was pro-minently longer than that in the control group[（34.2＆#177;0.17）weeks] with statistically significant difference（P＆lt;0.05）. The levels of total bilirubin （TBIL）,total bile acid （TBA） and alanine aminotransferase （ALT） after treatment in both groups declined to some extent,which,compared with the control group,had statistically significant difference（P＆lt;0.05）,and the levels of TBIL,TBA and ALT in the treatment groups declined more obviously than those in the control group with statistically significant difference （P＆lt;0.05）. Conclusion Transmetil combined with ursodeoxycholic acid is more effective than Transmetil alone in the treatment of intrahep-atic cholestasis of pregnancy.