摘要
目的探讨中西医结合治疗对妊娠肝内胆汁淤积症(ICP)胎盘血管内皮生长因子(VEGF)表达的影响。方法2006年1月至2008年12月在暨南大学第二临床医学院对孕周≥28周,<37周的ICP孕妇48例,其中20例用地塞米松(西药组),28例用中药结合地塞米松治疗(中西药组),同期入院后即分娩的ICP孕妇24例为未治疗组,正常足月孕妇20例为对照组。对比西药组、中西药组治疗前后生化指标的变化。比较各组的围产儿结局。用免疫组化方法检测各组胎盘VEGF的表达水平。结果中西药组治疗后,总胆汁酸、甘氨胆酸及丙氨酸转氨酶均明显下降(P<0.05),中西药组和未治疗组羊水粪染、胎儿窘迫、早产儿发生率分别为7.1%、3.6%、10.7%,33.3%、29.2%、41.7%,两组差异有统计学意义(P<0.05);与西药组早产儿发生率40.0%比较有统计学意义(P<0.05)。西药组治疗后仅总胆汁酸有所下降,围产儿结局与未治疗组相比无统计学意义(P>0.05)。中西药组胎盘VEGF的表达水平为(3.41±0.58)分,明显高于西药组的(2.51±0.44)分和未治疗组的(2.28±0.66)分(P<0.05);但低于对照组的(4.16±0.92)分(P<0.05)。结论中西医结合治疗能明显降低ICP患者的生化指标,改善围产儿结局。在一定程度上提高ICP患者胎盘VEGF的表达水平,可能是其主要的治疗机制。
Objective To investigate the effect of integrated traditional and western medicine therapy on placenta VEGF expression in ICP. Methods 48 ICP cases with gestational age lower than 37 weeks between Jan,2006 and Dec.2008 in the Second School of Clinical Medicine of Jinan University were enrolled. 20 of them,western medicine group,were treated with dexamethasone; the other 28 cases,the integrated group,were treated with the combination of herbal medicine and dexamethasone. Another 24 ICP cases that were admitted and delivered immediately during the same period were defined as untreated group. 20 normal term labor cases were enrolled as normal controls. The biochemical markers before and after the treatment were recorded. The perinatal outcomes and the expression level of VEGF in placentas among groups were analyzed. Results The concentration of total bile acid,glycocholic acid and alanine aminotransferase in the integrated group significantly decreased after treatment （P〈0.05）.The incidences of meconium-stained amniotic fluid,fetal distress and preterm labor were 7.1%,3.6% and 10.7% in the integrated ones,which were significantly lower than those in the untreated group which were 33.3%,29.2% and 41.7% correspondently（P〈0.05）. As for the western medicine group,only the total bile acid dropped a bit after the treatment but the perinatal outcome was similar to the untreated ones（P〈0.05）. 40% of them ended up in preterm labor,which was much higher than the integrated group（P〈0.05）.The expression level of placenta VEGF in the integrated group（3.41±0.58）score were higher than those in the western medicine ones（2.51±0.44）score and the untreated group（2.28±0.66）score but lower than those in the control group（4.16±0.92）score（P〈0.05）. Conclusion The integrated traditional and western medicine therapy can greatly improve biochemical markers in ICP patients and perinatal outcomes. This may be explained by its effect of increasing expression level of placenta VEGF.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2010年第1期50-52,共3页
Chinese Journal of Practical Gynecology and Obstetrics
基金
深圳市科技信息局课题(200602068)
关键词
妊娠肝内胆汁淤积症
胎盘
血管内皮生长因子
中西医结合
intrahepatic cholestasis of pregnancy
placenta
vascular endothelial growth factor
integrated traditional and western medicine
