丁二磺酸腺苷蛋氨酸与地塞米松联合对妊娠期肝内胆汁淤积患者疗效观察及对患者炎症因子和肝功能影响

Clinical efficacy of DL two sulfonic acid met methionine combined with dexamethasone in the treatment of intrahepatic cholestasis of pregnancy and its influence on inflammatory factors and liver function in patients with intrahepatic cholestasis of pregnan

[目的]探讨妊娠期肝内胆汁淤积患者应用丁二磺酸腺苷蛋氨酸与地塞米松联合治疗疗效及对患者炎症因子和肝功能影响。[方法]选自我院于2015年3月~2017年3月收治的妊娠期肝内胆汁淤积患者98例,按照随机表法分为观察组49例与对照组49例。对照组采用地塞米松治疗,观察组在对照组基础上结合丁二磺酸腺苷蛋氨酸治疗。2组疗程均为7d。比较2组治疗疗效,治疗前后瘙痒症状评分、炎症因子和肝功能指标变化,及围产儿结局。[结果]观察组治疗总有效率(93.88%)高于对照组(73.47%)(P<0.05)。2组治疗后瘙痒症状评分降低(观察组:t=38.0195,对照组:t=20.9042,P<0.05);观察组治疗后瘙痒症状评分低于对照组(t=26.3529,P<0.05)。2组治疗后IL-12降低而IL-4上升(观察组:t=45.8014、13.1525,对照组:t=24.3220、5.4033,P<0.05);观察组治疗后IL-12低于对照组而IL-4高于对照组(t=18.8016、7.3593,P<0.05)。2组治疗后AST和ALT水平降低(观察组:t=25.5940、24.4389,对照组:t=11.8117、10.6163,P<0.05);观察组治疗后AST和ALT水平低于对照组(t=20.1611、20.2102,P<0.05)。观察组新生儿窒息、胎儿窘迫和早产儿发生率低于对照组(P<0.05)。[结论]丁二磺酸腺苷蛋氨酸联合地塞米松治疗妊娠期肝内胆汁淤积患者临床疗效明显,且能够减轻炎症反应及改善患者肝功能。

[Objective] To investigate the clinical efficacy of DL two sulfonic acid met methionine com- bined with dexamethasone in the treatment of intrahepatic cholestasis of pregnancy and its influence on in- flammatory factors and liver function in patients with intrahepatic cholestasis of pregnancy. [Methods]98 patients with intrahepatic cholestasis of pregnancy admitted to our hospital from March 2015 to March 2017 were randomly divided into an observation group（49 cases）and a control group（49 cases）. The control group was treated with dexamethasone, and the observation group was treated with DL two sulfonic acid met methionine on the basis of the control group. The two groups were treated with 7 d. The therapeutic effect,pruritus score, inflammatory factors and liver function indexes, and perinatal outcomes were com- pared between the two groups. [Results] the total effective rate of the observation group （93.88%）was higher than that of the control group（73.47%） （P〈0.05）. The score of pruritus was lower in the two groups（observation group：t = 38. 0195, control group： t = 20. 9042, P〈0.05） ; the score of pruritus after treatment in the observation group was lower than that in the control group（t = 26. 3529, P〈0.05）. The two groups after treatment decreased I L-12 and increased IL-4 （observation group.t = 45.8014,13.1525, the control group.t= 24. 3220,5. 4033, P〈0.05） ; the patients in the observation group than in the control group IL-12 and IL-4 was higher than the control group（t=18. 8016,7. 3593,P〈0.05）. AST and ALT lev- els decreased in two groups after treatment（observation group ;t=25. 5940,24. 4389, the control group ：t=11. 8117,10. 6163,P〈0.05）;observation of AST and ALT levels after treatment were lower than those of the control group（t= 20. 1611,20. 2102,P%0.05）. The incidence of neonatal asphyxia, fetal distress and premature infants in the observation group was lower than that in the control group（P〈0.05）. [Conclu-sion]DL two sulfonic acid met methionine combined with dexamethasone is effective in the treatment of in- trahepatie cholestasis of pregnancy, and can improve irfflammatory factors and liver function in patients with intrahepatic cholestasis.