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目的探讨熊去氧胆酸及低分子肝素对妊娠期肝内胆汁淤积(ICP)症患者治疗中的价值及相关各项指标的变化。方法选取2009年6月～2010年12月在我院住院的ICP患者。分为2组,对照组为在常规西药治疗方法,观察组在常规西药治疗方法同时加用低分子肝素4000 IU皮下注射+熊去氧胆酸。比较2组治疗前后孕妇肝功能、空腹胆汁酸水平及血清TNF-α、VEGF变化。比较2组产后胎盘TNF-α变化。结果观察组及对照组治疗前后肝功能及空腹胆汁酸、VEGF均下降,观察组较对照组下降明显,差异有显著性。2组治疗前后血清TNF-α升高,差异无显著性。产后观察组胎盘TNF-α较对照组明显降低,差异有显著性。结论熊去氧胆酸+低分子肝素对ICP患者可有效改善治疗效果。联合治疗为临床治疗提供了新思路。
Objective To explore the value of ursodeoxycholic acid and low molecular weight heparin in the treatment of patients with intrahepatic cholestasis of pregnancy (ICP) during pregnancy and the related indexes. Methods ICP patients hospitalized in our hospital from June 2009 to December 2010 were selected. Divided into two groups, the control group for the treatment of conventional Western medicine, the observation group in the treatment of conventional Western medicine plus low molecular weight heparin 4000 IU + ursodeoxycholic acid subcutaneous injection. The changes of liver function, fasting bile acid and serum levels of TNF-α and VEGF in the two groups before and after treatment were compared. The changes of TNF-α in postpartum placenta of two groups were compared. Results The liver function, fasting bile acids and VEGF in the observation group and the control group decreased before and after treatment, and the observation group decreased significantly compared with the control group. The difference was significant. The levels of serum TNF-α increased in two groups before and after treatment, with no significant difference. Postpartum observation group placenta TNF-α was significantly lower than the control group, the difference was significant. Conclusion Ursodeoxycholic acid + low molecular weight heparin on ICP patients can effectively improve the therapeutic effect. Combination therapy provides a new idea for clinical treatment.