多烯磷脂酰胆碱对妊娠期胆汁淤积症患者的影响

Effect of polyene phosphatidylcholine on intrahepatic cholestasis of pregnancy

目的:探讨多烯磷脂酰胆碱对妊娠期胆汁淤积症(ICP)患者肝功能及妊娠结局的影响。方法:选择2014年12月至2016年12月我院84例ICP患者,依抽签法分成观察组和对照组,每组42例。对照组给予熊去氧胆酸加丁二磺酸腺苷蛋氨酸治疗,观察组于此基础上联合多烯磷脂酰胆碱治疗,均持续治疗10 d。比较2组入院时、治疗10 d后总胆红素(TBIL)、总胆汁酸(TBA)、谷草转氨酶(AST)、谷丙转氨酶(ALT)等肝功能指标的水平及治疗效果、妊娠结局。结果:入院时2组各项肝功能指标无显著性差异(均P>0.05),治疗后,观察组各项肝功能指标水平显著低于对照组(均P<0.05),观察组总有效率显著高于对照组(P<0.05),观察组早产率、剖宫产率、胎儿窘迫率、羊水粪染率均较对照组显著降低(均P<0.05)。结论:多烯磷脂酰胆碱治疗妊娠期胆汁淤积症患者效果显著,可有效改善其肝功能及妊娠结局,值得进一步深入探讨。

Objective： To investigate the effect of polyenophosphorylcholine on liver function and pregnancy outcome in women with intrahepatic cholestasis of pregnancy（ICP）. Methods： From December 2014 to December 2016,84 women with ICP were divided into control group and observation group according to the lottery method,42 cases in each group. The control group was treated with ursodeoxycholic acid plus ademetionine1,4-Butanedisulfonate; on the basis of this regimen,the observation group was treated with polyene phosphatidylcholine additionally; both groups were treated for 10 days. The levels of liver function indexes（TBIL,TBA,AST and ALT） were compared between the two groups on admission and 10 days after treatment. The therapeutic effect and pregnancy outcome were also compared. Results： There were no significant differences in TBIL,TBA,AST and ALT levels between the two groups on admission（P〈0. 05）,but the observation group demonstrated significantly lower levels of these indexes than the control group after treatment（P〈0. 05）. The total effective rate of the observation group was higher than that of the control group（P〉0. 05）. The rates of premature delivery,cesarean section,fetal distress and amniotic fluid of the observation group were significantly lower than those of the control group after treatment（P〈0. 05）. Conclusion： Polyene phosphatidylcholine is effective in the treatment of women with ICP,which can improve their liver functions and pregnancy outcome.