熊去氧胆酸与丁二磺酸腺苷蛋氨酸联合治疗妊娠期肝内胆汁淤积症的临床效果探析

Ursodeoxycholic Acid and Succinic Acid Adenosine Methionine Two Combination Therapy on the Clinical Effect of Intrahepatic Cholestasis of Pregnancy

目的:观察熊去氧胆酸与丁二磺酸腺苷蛋氨酸联合治疗妊娠期肝内胆汁淤积症的临床疗效。方法:把2014年1月-2014年12月新津县人民医院收治的50例妊娠期肝内胆汁淤积症患者分为对照组和观察组,各25例。对照组采用熊去氧胆酸治疗;观察组采用熊去氧胆酸与丁二磺酸腺苷蛋氨酸联合治疗。比较两组患者黄疸消退时间及治疗前后瘙痒评分变化;检测两组治疗前后血清总胆汁酸、甘胆酸以及肝酶的变化;观察两组胎儿宫内窘迫率,早产率,新生儿窒息率,死胎率,结果:观察组治疗后甘胆酸,血清总胆汁酸,肝酶较对照组明显下降,差异具有统计学意义(P<0.05)。与治疗前比,两组的甘胆酸、血清总胆汁酸、肝酶水平均下降,差异具有统计学意义(P<0.05),观察组较对照组的降低更显著,差异具有统计学意义(P<0.05)。观察组治疗之后的瘙痒评分以及黄疸消退的时间要明显优于对照组,差异具有统计学意义(P<0.05);胎儿宫内的早产率、窘迫率、窒息率等都要明显低于对照组,差异具有统计学意义(P<0.05)。结论:熊去氧胆酸与丁二磺酸腺苷蛋氨酸联合治疗妊娠期肝内胆汁淤积症具有显著的疗效。

Objective To observe the clinical curative effect of ursodeoxycholic acid combined with butyl two sulfonic acid adenosylmethionine in the treatment of intrahepatic cholestasis of pregnancy. Methods 50 cases of intrahepatic cholestasis of pregnancy patients were divided into control group （group A） and observation group （group B）, 25 cases in each. Group A were only given ursodeoxycholic acid treatment; while group B given ursodeoxycholic acid and butyl two sulfonic acid ademetionine treatment. Results The glycocholic acid, serum total bile acid, liver enzymes after treatment in group B were significantly lower than that in group A. （P 〈 0.05）. Two groups＇ glycocholic acid, total bile acids in serum and liver enzyme levels were reduced （P 〈 0.05）, while group B＇s level decreased more significantly than that in group A （P 〈 0.05）. Pruritus score and the time of jaundice in group B was superior to group A （P 〈 0.05）; Fetal distress, preterm birth rate, the rate of asphyxia rate in group B were significantly lower than those in group A （P 〈 0.05）. Conclusion Ursodeoxycholic acid combined with butyl two sulfonic acid ademetionine in treatment of intrahepatic cholestasis of pregnancy has significant curative effect.