熊脱氧酸对妊娠合并肝内胆汁淤积综合症患者血清甘胆酸、结合胆汁酸及sVCAM-1水平的影响

Effect of ursodeoxycholic acid on serum glucocholic acid,conjugated bile acid and sVCAM-1 in intrahepatic cholestasis of pregnancy

目的探讨熊脱氧酸对妊娠合并肝内胆汁淤积综合症患者甘胆酸(cholyglycine,CG)、结合胆汁酸(conjugated bile acid,CBA)及可溶性血管细胞粘附分子-1(soluble vascular cell adhesion molecules,sVCAM-1)水平的影响。方法收集温州医科大学附属第三医院妇产科收治的妊娠期肝内胆汁淤积症56例,随机分为对照组和实验组,每组各28例患者,对照组患者给予地塞米松治疗,实验组患者给予熊脱氧胆酸治疗,治疗7 d后,对所有患者的血清CG、CBA、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)及sVCAM-1水平进行检测。结果治疗后,与对照组比较,实验组患者的血清CG、TBA、ALT、AST及sVCAM-1水平明显较低,差异具有统计学意义(P<0.05)。结论熊脱氧酸能够显著降低妊娠合并肝内胆汁淤积综合症患者血清CG、TBA、ALT、AST及sVCAM-1水平,改善妊娠结局。

Objective To analyse the effect of ursodeoxycholic acid on serum levels of cholyglycine（ CG）,conjugated bile acid（ CBA） and soluble vascular cell adhesion molecules（ sVCAM-1） in patients with intrahepatic cholestasis of pregnancy. Methods 56 patients who were diagnosed with intrahepatic cholestasis of pregnancy in our hospital were collected. All patients were randomly divided into experimental group and control group,28 cases in each group. The control group were treated with dexamethasone, and the experimental group were treated with the treatment of ursodeoxycholic acid,after 7d of treatment,the serum levels of glucocholic acid,CBA,ALT,AST and sVCAM-1 were detected in all patients.Results After treatment,compared with control group,the serum CG,TBA,ALT,AST and sVCAM-1 levels were significantly lower in the experimental group,and the difference was statistically significant（ P〈0. 05）. Conclusion The ursodeoxycholic acid can significantly reduce the serum CG,TBA,ALT,AST and sVCAM-1 levels in patients with intrahepatic cholestasis of pregnancy,improve pregnancy outcome,with guidance significance for clinic.