谷胱甘肽片对妊娠期肝内胆汁淤积症的治疗效果

Effects of glutathione tablets on intrahepatic cholestasis of pregnancy

目的分析应用谷胱甘肽片对妊娠期内肝内胆汁淤积症患者肝功能指标和分娩结局的影响。方法选取福建省宁德市医院2013年3月至2017年4月间收治的妊娠期肝内胆汁淤积症孕妇214例作为研究对象,按照入院时的单双号作为随机分组方案,分为对照组和实验组,每组107例。两组患者均采用一般治疗方法,对照组患者应用熊去氧胆酸进行治疗,而实验组患者在熊去氧胆酸用药的基础上联合谷胱甘肽片进行治疗,对比两组患者的分娩结局以及各项肝功能指标。结果两组患者治疗后门冬氨酸转氨酶(AST)、胆汁酸(TBA)、丙氨酸转氨酶(ALT)水平均较治疗前显著降低(t=21.95~57.61,均P<0.05),而治疗后实验组患者的AST、TBA、ALT水平较对照组显著降低(t值分别为25.99、16.71、31.67,均P<0.05);实验组患者的阴道分娩率显著高于对照组(χ~2=15.02,P<0.05),而胎儿宫内窘迫发生率显著低于对照组(χ~2=5.68,P<0.05),两组患者的早产率和羊水污染率比较均无显著性差异(均P>0.05)。结论谷胱甘肽片能明显改善妊娠期肝内胆汁淤积症孕妇的肝功指标和分娩结局,提高患者的临床疗效,值得在临床上推广使用。

Objective To explore the effect of glutathione tablets on liver function indexes and childbirth outcome of pregnant women with intrahepatic cholestasis.Methods Altogether 214 pregnant women with intrahepatic cholestasis admitted in Ningde City Hospital from March 2013 to April 2017 were selected as research objects,and with odd-even admission number as a random grouping scheme,patients were divided into control group and experimental group,including 107 patients in each group.Both groups received regular treatment.Patients in control group were treated with ursodeoxycholic acid,and patients in experimental group received glutathione on basis of ursodeoxycholic acid.Childbirth outcomes and liver function indicators in two groups were compared.Results Aspartate aminotransferase（AST）,total bile acid（TBA）,alanine transaminase（ALT）in two groups after treatment were significantly lower than those before treatment（t value ranged 21.95-57.61,all P〈0.05）.AST,TBA and ALT after treatment in experimental group were significantly lower than those in control group（t value was 25.99,16.71,31.67 respectively,all P〈0.05）.Vaginal delivery rate in experimental group was significantly higher than that in control group（χ~2=15.02,P〈0.05）,and fetal intrauterine distress rate in experimental group was significantly lower than that in control group（χ~2=5.68,P〈0.05）.Preterm birth rate and amniotic fluid contamination rate in two groups had no statistically significant difference（all P〈0.05）.Conclusion Glutathione tablets can effectively improve liver function indexes and childbirth outcomes in patients with intrahepatic cholestasis of pregnancy,and increase clinical effect.It is worth popularization in clinical use.