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

摘要

目的 分析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2014年2月至2016年2月收治的妊娠期肝内胆汁淤积症患者104例,参照抽签法分为对照组和治疗组,每组52例,对照组予以熊去氧胆酸治疗,治疗组予以丁二磺酸腺苷蛋氨酸治疗,比较2组瘙痒评分、胆汁酸(TBA)、肝酶指标[谷草转移氨酶(AST)、谷丙转氨酶(ALT)]、妊娠结局.结果 治疗后,治疗组瘙痒评分[(1.26±0.13)分]低于对照组[(2.53±0.27)分],差异有统计学意义(P<0.05);治疗组TBA[(12.07±3.15)μmol/L]低于对照组[(16.34±3.27)μmol/L](P<0.05);治疗组AST[(45.93±9.74)U/A]、ALT[(51.35±10.20)U/A]低于对照组[(57.82±11.64)U/A、(62.57±12.56)U/A],差异有统计学意义(P<0.05);治疗组羊水污染7.69%(4/52)、胎儿窘迫3.85%(2/52)、早产3.85%(2/52)、剖宫产25.00%(13/52)、Apgar评分<7分1.92%(1/52)均低于对照组[23.08%(12/50)、15.385(8/52)、17.31%(9/52)、44.23%(23/52)、13.46%(7/52)],差异有统计学意义(P<0.05).结论 丁二磺酸腺苷蛋氨酸对于妊娠期肝内胆汁淤积症患者疗效确切,能够有效降低胆汁酸及肝酶指标水平,改善妊娠期结局.%Objective To investigate the effects of transmetil on bile acid,liver enzyme indexes and pregnancy outcome of patients with intrahepatic cholestasis of pregnancy (ICP).Methods One hundred and four patients with ICP who were admitted and treated in our hospital from February 2014 to February 2016 were divided into control group ( n =52) and observation group ( n =52) according to lot method.The 52 patients in control group were treated by ursodeoxycholic acid,however,the other 52 patients in observation group were treated by transmetil.The pruritus score,bile acid (TBA),liver enzyme index [aspertate transaminase (AST),alanine aminotransferase (ALT)]and pregnancy outcome were observed and compared between two groups.Results After treatment,the pruritus scores (1.26+0.13) in observation group were significantly lower than those (2.53±0.27) in control group ( P <0.05).The levels of TBA (12.07±3.15)μmol/L were obviously lower than those (16.34±3.27)μmol/L in control group ( P <0.05).The levels of AST (45.93±9.74) U/A,ALT (51.35±10.20) U/A in observation group were significantly lower than those in control group (57.82±11.64) U/A,(62.57±12.56) U/A,respectively ( P <0.05).Moreover the incidence rates of fetal distress 7.69% (4/52),amniotic fluid pollution 3.85% (2/52),premature 3.85% (2/52),cesarean section 25.00% (13/52),Apgar score <7 points 1.92% (1/52) in observation group were significantly lower than those in control group,which were 23.08% (12/50),15.38% (8/52),17.31% (9/52),44.23% (23/52),13.46% (7/52),respectively ( P <0.05).Conclusion The transmetil has definite therapeutic effects on ICP,which can effectively reduce the levels of bile acid and liver enzyme indexes of patients and can improve pregnancy outcome.