熊去氧胆酸对妊娠期肝内胆汁淤积症患者妊娠结局的影响

Effect of ursodeoxycholic acid on pregnancy outcome in patients with intrahepatic cholestasis of pregnancy

目的探讨熊去氧胆酸对妊娠期肝内胆汁淤积症(ICP)患者妊娠结局的影响。方法选取2012年1月~2018年4月我院妇产科住院治疗ICP患者90例,随机分为观察组和对照组,每组各45例。对照组均予以能量合剂等常规治疗。观察组在对照组基础上加用熊去氧胆酸0.25 g/次,2次/d,口服,两组连用14 d。观察两组治疗前和治疗7 d后肝功能水平变化,并比较其临床疗效及妊娠结局。结果治疗14 d后,两组血清TBA、ALT和AST水平均较治疗前显著下降(P<0.01或P<0.05),且观察组下降值大于对照组(P<0.05);同时观察组临床总有效率较对照组更佳(χ^2=4.54,P<0.05)。观察组发生不良妊娠结局4例(8.88%),对照组11例(24.44%),观察组不良妊娠结局发生率低于对照组(χ^2=3.92,P<0.05)。结论熊去氧胆酸治疗ICP患者的效果确切,能明显改善肝功能指标;降低不良妊娠结局,保护母婴安全。

Objective To investigate the effect of ursodeoxycholic acid on pregnancy outcome in patients with intrahepatic cholestasis of pregnancy(ICP).Methods 90 patients with ICP in the department of obstetrics and gynaecology in our hospital from January 2012 to April 2018 were randomly divided into observation group and control group,with 45 cases in each group.The control group was given conventional treatment such as energy mixture.The observation group was treated with ursodeoxycholic acid 0.25 g/time,twice/d,orally,based on the treatment of the control group.The two groups were treated for 14 days.The changes of liver function before and after 7 days of treatment were observed,and the clinical efficacy and pregnancy outcome were compared.Results After 14 days of treatment,the serum levels of TBA,ALT and AST in the two groups were significantly lower than those before treatment(P<0.01 or P<0.05),and the decrease in the observation group was greater than that in the control group(P<0.05).At the same time,the total effective rate of the observation group was better than that of the control group(χ^2=4.54,P<0.05).There were 4 cases(8.88%)of adverse pregnancy outcomes in the observation group and 11 cases(24.44%)in the control group.The incidence of adverse pregnancy outcomes in the observation group was lower than that in the control group(χ^2=3.92,P<0.05).Conclusion Ursodeoxycholic acid in the treatment of ICP patients has positive effect,which can significantly improve liver function indicators,reduce adverse pregnancy outcomes and protect maternal and child safety.