熊去氧胆酸联合腺苷蛋氨酸治疗妊娠期肝内胆汁於积症的机制

Action mechanism of ursodeoxycholic acid combined with ademetionine against intrahepatic cholestasis during pregnancy

目的:探究熊去氧胆酸联合腺苷蛋氨酸治疗妊娠期肝内胆汁於积症的机制。方法:选取某院收治的160例妊娠期肝内胆汁於积症患者,按随机数字表法将患者分为观察组和对照组,每组各80例,对照组给予熊去氧胆酸治疗,观察组给予熊去氧胆酸联合腺苷蛋氨酸的治疗,治疗前和治疗后检测妊娠期肝内胆汁於积症患者血液流变学指标、炎症因子、凝血功能和肝功能及相关生化指标的变化情况。结果:与本组治疗前和治疗后的对照组相比,观察组经过熊去氧胆酸联合腺苷蛋氨酸治疗后炎症因子IL-6、IL-8、TNF-α显著降低,IL-10显著升高;凝血功能指标PT变化不明显,APTT、FIB、D-D显著降低,PLT显著升高;血液流变学相关指标及肝功能和相关生化指标(TB、DB、TBA)显著降低,比较差异存在统计学意义(P<0.05);与治疗前对照组相比,治疗后对照组炎症因子(IL-6、IL-8、TNF-α)、生化指标、血液流变学、FIB、D-D显著降低(P<0.05),IL-10、PLT显著升高(P<0.05),PT、APTT变化不明显(P>0.05)。结论:熊去氧胆酸联合腺苷蛋氨酸的治疗能够改善妊娠期肝内胆汁於积症患者血液流变学指标、炎症因子、凝血功能和肝功能及相关生化指标,为妊娠期肝内胆汁於积症患者的临床治疗提供帮助。

OBJECTIVE To observe the mechanism of ursodeoxycholic acid combined with ademetionine against intrahepatic cholestasis during pregnancy.METHODS A total of 160 patients with intrahepatic cholestasis during pregnancy were selected and randomly divided into observation group（80 patients）and control group（80 patients）.Patients were treated with ursodeoxycholic acid in the control group and with ursodeoxycholic acid combined with ademetionine in the observation group.Hemodynamic indexes,inflammatory factors,blood coagulation,liver function and biochemical indicator were compared before and after fifteen days of therapy.RESULTS Blood coagulation（APTT,FIB,D-D,PLT）,inflammatory factors（IL-6,IL-8,TNF-α）,hemodynamic indexes,liver function and biochemical indicators（TB,DB,TBA）decreased significantly in the observation group after treatment,IL-10 increased significantly in the observation group after treatment（P〈0.05）.The variation of PT was not obvious in the observation group（P〈0.05）.After treatment,blood coagulation（APTT,FIB,D-D,PLT）,inflammatory factors（IL-6,IL-8,TNF-α）,hemodynamic indexes,liver function and biochemical indicator（TB,DB,TBA）decreased significantly in the observation group than those in control group,IL-10 increased significantly in the observation group than in control group（P〈0.05）.The variation of PT in the observation group was not obvious（P〉0.05）.In control group,inflammatory factors（IL-6,IL-8,TNF-α）,biochemical indexes,blood rheology,FIB,D-D significantly decreased after treatment（P〈0.05）,IL-10 and PLT significantly increased after treatment（P〈0.05）,changes of PT and APTT were not obvious（P〉0.05）.CONCLUSION Ursodeoxycholic acid combined with ademetionine can effectively improve hemodynamic indexes,inflammatory factors,blood coagulation,liver function and biochemical indicators in patients with intrahepatic cholestasis during pregnancy,and it has important clinical significance for patients with intrahepatic cholestasis during pregnancy.