腺苷蛋氨酸联合熊去氧胆酸治疗妊娠期肝内胆汁淤积症的临床研究

Combination of S-adenosy-L-methionine and Ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy

目的 评估腺苷蛋氨酸 (SAMe)联合熊去氧胆酸 (UDCA)治疗妊娠期肝内胆汁淤积症 (ICP)的效果。方法 选择 6 3例ICP患者 ,随机分成 3组 ,SAMe联合UDCA组 (A组 ,2 1例 )采用SAMe 10 0 0mg加 5 %葡萄糖液 5 0 0ml静滴 ,1次 /d ,UDCA 10 0mg/次 ,3次 /d ,10天为 1个疗程。SAMe对照组 (B组 ) :用SAMe 10 0 0mg加 5 %葡萄糖液 5 0 0ml静滴 ,1次 /d,10天为 1个疗程。UDCA对照组 (C组 ) :单用UDCA 10 0mg/次 ,3次 /d ,10天为 1个疗程 ,观察 3组的疗效。结果 治疗后 3组患者瘙痒症状的评分间差别有显著性意义 (P <0 0 1)。治疗后 3组患者血清TBA、AST、ALT、TBil、DBil含量间的差别均有显著性意义 (P <0 0 1)。妊娠结局 :A组新生儿早产率 ,羊水污染率 ,新生儿窒息率与B组、C组间差别均有显著性意义。 3组患者新生儿体重间的差别也有显著性意义 (P <0 0 1)。结论 SAMe联合UDCA是治疗ICP的安全有效的方法 ,可改善妊娠预后。

Objective To observe the efficacy of S-adenosy-L-methionine(SAMe) and ursodeoxychilic acid(UDCA) in the treatment of intrahepatic cholestasis of pregnancy.Methods 63 patients were randomly divided into three groups:Group A receiving a combination of SAMe 1000mg,5% glucose 500ml/d,UDCA 100mg 3/d for 10 days;Group B receiving SAMe 1000mg and 5% glucose 500ml/d for 10 days;Group C receiving UDCA 100mg 3/d for 10 days,Before and after treatment,the liver function and itch score were measured.Results After seven days,there were significant differences in pruritrs,TBA,AST,ALT,TBil,DBil in receiving combination of SAMe and UDCA comparing with receiving SAMe or UDCA(P<0 05).The newborn weight and Apgar score >7 were increased.Conclusion Combination of SAMe and UDCA are safe,efficient,good treatment.The prognosis of pregnancy is improved.