腺苷蛋氨酸治疗妊娠期肝内胆汁淤积症的价值分析

Analysis of the Value of Adenosylmethionine in the Treatment of Intrahepatic Cholestasis of Pregnancy

目的探讨对妊娠期肝内胆汁淤积症采用腺苷蛋氨酸治疗的临床效果。方法选择该院2019年1月—2020年6月收治妊娠期肝内胆汁淤积症患者110例,随机分为熊去氧胆酸治疗对照组(n=55)与联合腺苷蛋氨酸治疗研究组(n=55),治疗后1~2个月随访,评价瘙痒改善情况、肝功能指标以及妊娠结局。结果治疗后研究组瘙痒症状评分为(0.41±0.10)分,低于对照组(2.08±0.91)分,差异有统计学意义(t=13.529,P<0.05)。研究组治疗后TBIL、ALT、TBA、AST水平分别为(20.84±5.17)μmol/L、(78.15±11.58)U/L、(17.24±5.51)μmol/L、(66.45±14.12)U/L,均低于对照组,差异有统计学意义(t=12.699、15.031、10.331、13.857,P<0.05)。研究组早产率16.36%(9/55),低于对照组47.27%(26/55),差异有统计学意义(χ^(2)=12.111,P=0.001)。结论对妊娠期肝内胆汁淤积症采用腺苷蛋氨酸治疗可减轻瘙痒症状,改善肝功能与妊娠结局。

Objective To investigate the clinical effect of adenosylmethionine in the treatment of intrahepatic cholestasis of pregnancy.Methods From January 2019 to June 2020,110 patients with intrahepatic cholestasis of pregnancy were selected and randomly divided into ursodeoxycholic acid treatment control group(n=55)and combined adenosylmethionine treatment study group(n=55),followed up 1 to 2 months after treatment to evaluate the improvement of pruritus,liver function indexes and pregnancy outcome.Results After treatment,the score of pruritus in the study group was(0.41±0.10)points,which was lower than the control group(2.08±0.91)points,the difference was statistically significant(t=13.529,P<0.05).After treatment,the levels of TBIL,ALT,TBA and AST in the study group were(20.84±5.17)μmol/L,(78.15±11.58)U/L,(17.24±5.51)μmol/L,(66.45±14.12)U/L,all were lower than the control group,the difference was statistically significant(t=12.699,15.031,10.331,13.857,P<0.05).The preterm birth rate of the study group was 16.36%(9/55),which was lower than that of the control group 47.27%(26/55),the difference was statistically significant(χ^(2)=12.111,P=0.001).Conclusion The treatment of intrahepatic cholestasis during pregnancy with adenosylmethionine can reduce the symptoms of itching,improve liver function and pregnancy outcome.