S-腺苷甲硫氨酸联合还原型谷胱甘肽治疗妊娠期肝内胆汁淤积症

Clinical Effect of Reduced Glutathione Combined with S-adenosylmethionine in the Treatment of Pregnancy Complicated with Biliary Sludge

目的:探讨S-腺苷甲硫氨酸(S-adenosylmethionine,SAM)联合还原型谷胱甘肽治疗妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)的临床效果。方法:选取本院2012年1月-2015年6月收治的117例ICP患者采用SPSS 16.0软件生成随机数字表后分为联合组58例和对照组59例,2组患者均采用SAM+常规治疗,联合组加用还原型谷胱甘肽治疗,2组患者的疗程均为4周,对比2组的治疗效果。结果:治疗前联合组和对照组的血总胆汁酸(TBA)、谷丙转氨酶(ALT)、谷草转氨酶(AST)水平及瘙痒程度评分差异无统计学意义(P>0.05);治疗后2组患者的血TBA、ALT、AST水平及瘙痒程度评分均较本组治疗前显著降低(P<0.05);治疗后,联合组患者的血TBA、ALT、AST水平及瘙痒程度评分低于对照组患者,差异有统计学意义(P<0.05);2组分娩孕周、胎儿窘迫、Apgar评分及新生儿体质量比较,差异无统计学意义(均P>0.05);联合组剖宫产率显著低于对照组,差异有统计学意义(P<0.05)。结论:还原型谷胱甘肽联合SAM治疗ICP较单用SAM具有更加显著的临床效果。

Objective：To study the clinical effect of reduced glutathione combined with S-adenosylmethionine（SAM） in the treatment of intrahepatic cholestasis of pregnancy（ICP）. Methods：117 patients with ICP in our hospital from January 2012 to June 2015 were selected by SPSS 16.0 software to generate random number table and divided into the joint group 58 cases and control group 59 cases. The control group was treated with SAM, joint group was treated with SAM ＋ glutathione, the therapeutic effect were compared after four weeks. Results：Before treatment, There was no significant difference in blood TBA,ALT, AST levels and pruritus severity score between the combination group and the control group before treatment（ P 〉0.05）. The blood TBA, ALT, AST levels and pruritus severity score were significantly reduced after treatment in both group（ P 〉0.05）. After treatment, the blood TBA, ALT, AST levels and pruritus scores of the combined group were significantly lower than the control group patients（P 〈0.05）. There were no differences in gestational age, fetal distress, Apgar scores and birth weight between two groups（P 〈0.05）. The cesarean section rate in combined group was significantly lower than the control group（ P 〉0.05）. Conclusions：Glutathione combined SAM was more effective than single SAM in the treatment of intrahepatic cholestasis of pregnancy.