熊去氧胆酸结合丁二磺酸腺苷蛋氨酸治疗妊娠期肝内胆汁淤积症疗效及对不良妊娠结局的影响

Effect of ursodeoxycholic acid combined with ademetionine on intrahepatic cholestasis of pregnancy and adverse pregnancy outcomes

目的:探讨熊去氧胆酸(UDCA)结合丁二磺酸腺苷蛋氨酸治疗妊娠期肝内胆汁淤积症(ICP)的疗效及对不良妊娠结局的影响。方法:将106例ICP患者按照治疗方式不同分为联合组和对照组,每组各53例。对照组予以丁二磺酸腺苷蛋氨酸和常规治疗;联合组在对照组的基础上予以UDCA治疗。比较两组临床转归情况、肝功能指标、临床疗效和妊娠结局。结果:治疗后,联合组黄疸和瘙痒症状消失时间均少于对照组(P<0.05);总胆红素(TBIL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、血清总胆汁酸(TBA)水平及早产、新生儿窒息发生率均低于对照组(P<0.05);Apgar评分及新生儿体重均高于对照组(P<0.05);联合组临床治疗总有效率优于对照组(90.57%vs.73.58%,P<0.05)。结论:UDCA结合丁二磺酸腺苷蛋氨酸治疗ICP可有效调节胆汁酸水平,改善肝功能和不良妊娠结局,疗效较显著。

Objective:To investigate the curative effect of ursodeoxycholic acid(UDCA)combined with ademetionine on intrahepatic cholestasis of pregnancy(ICP)and its influences on adverse pregnancy outcomes.Methods:A total of 106 patients with ICP were divided into combination group and control group according to different treatment methods,53 cases in each group.The control group was given ademetionine and routine treatment,while combination group was additionally given UDCA on the basis of the control group.The clinical outcomes,liver function indexes,clinical curative effect and pregnancy outcomes were compared between the two groups.Results:After treatment,disappearance time of jaundice and pruritus in combination group was shorter than that in control group(P<0.05).The levels of total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bile acid(TBA)as well as the incidence of premature delivery and neonatal asphyxia in combination group were lower than those in control group(P<0.05).The Apgar score and neonatal body weight were higher than those in control group(P<0.05).The total clinical response rate of combination group was better than that of control group(90.57%vs.73.58%,P<0.05).Conclusion:Treatment of ICP with UDCA combined with ademetionine can effectively regulate level of bile acid,improve liver function and adverse pregnancy outcomes,and which has significant efficacy.