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目的探讨S-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)的临床疗效。方法选取青岛市第八人民医院2013年5月—2015年8月收治的76例ICP患者,按照随机对照原则将患者分为观察组与对照组,各38例,观察组患者给予SAMe联合UDCA治疗,对照组患者给予UDCA治疗,比较两组患者治疗后血清总胆酸(TBA)、总胆红素(TBil)、直接胆红素(DBil)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、血清甘胆酸(CG)。同时对患者进行随访,观察两组患者的妊娠结局及不良反应发生情况。结果治疗后观察组患者血清TBA、TBil、DBil、ALT、AST及CG水平低于对照组,差异有统计学意义(P<0.05)。观察组患者剖宫产、羊水粪染、胎儿窘迫及新生儿窒息发生率低于对照组,差异有统计学意义(P<0.05)。两组患者均未出现肝肾功能损害等不良反应。结论 SAMe联合UDCA治疗ICP的临床疗效确切,能够有效改善患者的临床症状和母婴结局。
Objective To investigate the clinical efficacy of S-adenosylmethionine (SAMe) combined with ursodeoxycholic acid (UDCA) in the treatment of intrahepatic cholestasis of pregnancy (ICP). Methods Sixty-seven patients with ICP who were treated in Qingdao Eighth People’s Hospital from May 2013 to August 2015 were divided into observation group (38 cases) and control group (38 cases) according to the principle of randomized control. Patients in observation group were given SAMe combined with UDCA , And the control group were treated with UDCA. The levels of serum total bile acid (TBA), total bilirubin (TBil), direct bilirubin (DBil), alanine aminotransferase (ALT) Aminotransferase (AST), serum glycocholic acid (CG). At the same time, patients were followed up to observe the pregnancy outcome and adverse reactions in both groups. Results After treatment, the levels of serum TBA, TBil, DBil, ALT, AST and CG in the observation group were lower than those in the control group, with statistical significance (P <0.05). The incidence of cesarean section, meconium-stained amniotic fluid, fetal distress and neonatal asphyxia in the observation group were significantly lower than those in the control group (P <0.05). Two groups of patients did not appear adverse reactions such as liver and kidney dysfunction. Conclusions The clinical efficacy of SAMe combined with UDCA in the treatment of ICP is accurate and can effectively improve the clinical symptoms and maternal-infant outcome.