熊去氧胆酸联合S-腺苷蛋氨酸治疗妊娠期轻度肝内胆汁淤积症的疗效观察

摘要

OBJECTIVE:To observe therapeutic efficacy of ursodeoxycholic acid(UDCA)combined with S-adenosyl methio-nine (SAMe) in the treatment of mild intrahepatic cholestasis (ICP) of pregnancy. METHODS:213 pregnant patients with mild ICP were selected and randomly divided into combination group (107 cases) and single drug group (106 cases). Combination group received UDCA combined with SAMe,and single drug group was given UDCA alone. Therapeutic efficacy and pregnancy outcome were compared between 2 groups. RESULTS:Compared to before treatment,TBA,CG,DBIL,ALT and AST of 2 groups were decreased after treatment,and the decrease of combination group was more significant than that of single drug group, with statistical significance(P0.05);the preterm birth rate of combination group was 11.22%,which was significantly lower than 20.75% of single drug group,with statistical significance(P<0.05). CONCLUSIONS:Compared to UD-CA alone,UDCA combined with SAMe in the treatment of patients with ICP can control the clinical symptoms timely,recovery laboratory index as soon as possible and obtain better therapeutic efficacy.%目的：观察熊去氧胆酸（UDCA）联合S-腺苷蛋氨酸（SAMe）治疗妊娠期轻度肝内胆汁淤积症（ICP）的疗效。方法：选取妊娠期轻度ICP患者213例，按随机数字表法分为联合组（107例）和单药组（106例）。联合组患者采用UDCA联合SAMe治疗，单药组采用UDCA治疗，比较两组患者的疗效及妊娠结局差异。结果：治疗后两组患者的总胆汁酸、肝胆酸、直接胆红素、丙氨酸转氨酶、天冬氨酸转氨酶检测值较治疗前均降低，联合组降低较单药组更加显著，差异均有统计学意义（P＜0.05）；联合组患者的瘙痒控制时间[（3.8±1.4）d]短于单药组[（5.3±1.5）d]，差异有统计学意义（P＜0.05）；治疗后第3、5天联合组患者的瘙痒程度评分低于单药组患者，差异具有统计学意义（P＜0.05）；联合组与单药组的胎儿窘迫发生率、新生儿窒息发生率、羊水污染率、剖宫产率、新生儿1 min Apgar评分比较，差异均无统计学意义（P＞0.05）；联合组患者的早产率为11.22％，显著低于单药组的20.75％，差异具有统计学意义（P＜0.05）。结论：UDCA联合SAMe治疗ICP患者较单用UDCA治疗能够更及时地控制患者的临床症状，尽快恢复实验室指标，取得更好的疗效。