摘要
目的探索及分析多烯磷脂酰胆碱联合丁二磺酸腺苷蛋氨酸对妊娠期肝内胆汁淤积症患者胆汁酸、肝酶指标及妊娠期结局的影响。方法收集本院产科病房2013年7月—2017年5月接收的患妊娠期肝内胆汁淤积症的78例患者,随机分成2组:参考组共39例,给予熊去氧胆酸+注射用丁二磺酸腺苷蛋氨酸治疗;研究组共39例,在参考组治疗的基础上,给予多烯磷脂酰胆碱用药治疗。观察两组患者的瘙痒程度变化、肝酶指标、胆汁酸水平变化,且详细记录两组的妊娠结局情况。结果研究组治疗后的瘙痒评分与治疗前、参考组相比显著更低(P<0.05);研究组治疗后的AST、ALT等肝酶指标及胆汁酸水平与治疗前、参考组相比显著更低(P<0.05);研究组的宫内窘迫、羊水污染、剖宫产、早产及Apgar评分<7分等发生率与参考组相比显著更低(P<0.05)。结论针对妊娠期肝内胆汁淤积症患者以熊去氧胆酸、多烯磷脂酰胆碱联合丁二磺酸腺苷蛋氨酸用药治疗可达良好的疗效,可明显降低其肝酶指标与胆汁酸水平,促进妊娠结局的改善,值得借鉴。
Objective To explore and analyze the effects of polyenoic phosphatidylcholine combined with Ademetionine1,4-butanedisulfonate on bile acid,liver enzyme and outcome of gestation in patients with gestational intrahepatic cholestasis.Methods This study enrolled 78 cases of patients suffered gestational intrahepatic cholestasis,the patients received therapy in obstetric ward in our hospital during July 2013 and May2017.The patients were randomly divided into 2 groups.There were 39 cases in the in the reference group,they received ursodeoxycholic acid plus Ademetionine1,4-butanedisulfonate for the treatment.The 39 cases in thestudy group were treated with polyene phosphatidylcholine additionally on the basis of the reference group.The changes of pruritus degree,liver enzyme index and bile acid level of two groups were observed,and the pregnancy outcomes of two groups were recorded in detail.Results The scores of pruritus in the study group decreased significantly after the treatment,and less than that of the reference group（P〈0.05）.The concentration of AST,ALT and bile acid in serums of patients in study group decreased significantly after the treatment,and less than that of the reference group（P〈0.05）.The occurrence rates of fetal distress,amniotic fluid pollution,cesarean section,premature delivery and Apgar score less than 7 in study group were statistically lower than those in the reference group（P〈0.05）.Conclusions The application of ursodeoxycholic acid,polyene phosphatidylcholine and Ademetionine1,4-butanedisulfonate in patients with gestational intrahepatic cholestasis,could decrease the concentration of liver enzymes indexes and bile acid,promote pregnancy outcomes,which worth of reference.
作者
刘益华
王菲
LIU Yi-hua(Department of Obstetrics and Gynecology,naval Anqing hospital Anqing,Anhui,246000,China)
出处
《齐齐哈尔医学院学报》
2018年第8期890-892,共3页
Journal of Qiqihar Medical University
关键词
妊娠期肝内胆汁淤积症
丁二磺酸腺苷蛋氨酸
肝酶
胆汁酸
妊娠结局
Gestational intrahepatic cholestasis
Ademetionine 1
4 - butanedisulfonate
Liverenzymes
Bile acid
Pregnancy outcome
