丁二磺酸腺苷蛋氨酸联合地塞米松对妊娠期肝内胆汁淤积症患者免疫功能及疗效的影响

The Therapeutic Effect of Succinic Acid Adenosine Methionine Combined with Dexamethasone in Patients with Intrahepatic Cholestasis of Pregnancy and Its Influences on Immune Function

目的:探讨丁二磺酸腺苷蛋氨酸联合地塞米松对妊娠期肝内胆汁淤积症(ICP)患者免疫功能及疗效的影响。方法:选取2013年9月—2015年9月住院的ICP患者78例,将所有研究对象分为观察组与对照组,各39例,对照组采用丁二磺酸腺苷蛋氨酸治疗,观察组采用丁二磺酸腺苷蛋氨酸联用地塞米松联合治疗。比较2组治疗前后血清总胆汁酸(TBA)、总胆红素(TBIL)、直接胆红素(DBIL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、白细胞介素12(IL-12)及肿瘤坏死因子α(TNF-α)水平,比较2组产后胎盘组织中TNF-α的表达水平及治疗效果。结果:观察组的治疗效果优于对照组,妊娠结局与围生儿状况同样优于对照组(P<0.05)。2组患者治疗后TBA、TBIL、ALT、AST及IL-12水平均明显下降(P<0.05),且观察组较对照组下降更明显(P<0.05)。观察组DBIL、TNF-α及产后胎盘TNF-α水平均低于对照组,观察组各指标治疗前后差值均高于对照组(P<0.05)。结论:丁二磺酸腺苷蛋氨酸联合地塞米松治疗ICP,在缓解患者临床体征、降低血胆汁酸及改善肝功能等方面有显著的临床效果,并可改善患者的免疫功能状态、妊娠结局及围生儿状况。

Objective：To investigate the therapeutic effect of succinic acid adenosine methionine combined with dexamethasone in patients with intrahepatic cholestasis of pregnancy and its influences on immune function. Methods：78 patients with intrahepatic cholestasis of pregnancy who were admitted into our hospital from September 2013 to September 2015 were divided into two groups （39 cases in each group）. The control group was treated with succinic acid adenosine methionine, while the observation group received succinic acid adenosine methionine combined with dexamethasone. The serum levels of TBA, TBIL, DBIL, ALT, AST, IL-12 and TNF-αin both groups before and after treatment were observed and compared. The level of TNF-αin placenta tissue and therapeutic effect and were compared in the two groups. Results：The therapeutic effect of observation group was better than that in control group （P〈0.05）, perinatal outcome of pregnancy maternal and perinatal status of child were also better than control group. After treatment, the serum level of TBA, TBIL, ALT, AST and IL-12 in both groups were lowered than before , the observation group were significantly declined than the control group（ P〈0.05）. The levels of DBIL, TNF-αand placenta′s TNF-αin observation group were obviously lower than in control group （P〈0.05）. For observation group, each index difference before and after the treatment were higher than the control group （ P〈0.05）. Conclusions：Succinic acid adenosine methionine combined with dexamethasone is marked effective in treating patients with ICP, which can obviously alleviate the patient＆#39;s clinical symptoms, reduce the blood bile acid, and significantly improve liver function and immune function, improve perinatal outcome of pregnancy maternal and perinatal status of child.