妊娠期肝内胆汁淤积症治疗的临床分析  

A clinical analysis of therapeutic effect for 126 cases of ICP

作　　者：程志霞[1] 郭靖[1] 

机构地区：[1]西安市红十字会医院,陕西西安710054

出　　处：《中国妇幼健康研究》2008年第2期124-126,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨临床治疗妊娠期肝内胆汁淤积症的疗效。方法采用回顾性分析西安市红十字会医院5年来收治的126例妊娠期肝内胆汁淤积症患者的临床资料,随机分为研究组(66例)和对照组(60例),采用不同方法治疗后,观察其治疗指标变化,并对分娩后情况进行统计分析。结果两组患者治疗后瘙痒评分、血清甘胆酸、谷丙转氨酶、谷草转氨酶、总胆红素与直接胆红素的含量平均较治疗前低(研究组:t值分别为3.61、3.45、3.23、3.46、3.25、3.42,均P<0.01;对照组:t值分别为3.21、2.45、2.74、2.68、2.80、2.77,均P<0.01);研究组治疗前后瘙痒评分、血清甘胆酸、谷丙转氨酶、谷草转氨酶、总胆红素与直接胆红素的含量的差值水平较对照组大(t值分别为2.21、2.09、2.03、2.15、2.05、2.11;均P<0.05);治疗后,研究组胎儿窘迫、早产及新生儿窒息的发生率较对照组低(2χ值分别为3.88、4.99、3.95;均P<0.05)。结论思美泰与熊去氧胆酸联合用药能提高妊娠期肝内胆汁淤积症的疗效,尤其对于重症患者有更明显的疗效,可以改善新生儿的预后。Objective To investigate therapeutic effect for intrahepatic cholestasis of pregnancy（ICP） in clinic. Methods The clinical data of 126 parturients with ICP treated in our hospital in recent 5 years were retrospectively analyzed. The patients with ICP were divided into study group （ n = 66） and control group （ n = 60） randomly and were treated with different drugs. The clinical therapeutic indexes of the patients in the two groups were observed and pregnancy outcomes were analyzed statistically. Results After treatment, the scores in pruritus, serum levels of CG, TBA, ALT, AST, TB and DB of the patients in the two groups were lowered significantly （ in the study group： t=3.61, 3.45, 3.23, 3.46, 3.25, 3.42, respectively, all P〈0.05; in the control group： t = 2.21, 2.45, 2.74, 2.68, 2.80, 2.77, respectively, all P 〈0.01 ）. The differences in scores in pruritus, serum levels of CG, TBA, ALT, AST, TB and DB of the patients in the study group before and after treatment were greater than those in the control group （t = 2.21, 2.09, 2.03, 2.15, 2.05, 2.11 respectively, all P 〈 0.05 ）. After treatment, the incidence rates of fetal distress, premature delivery and neonatal asphyxia in the study group were also lower than those in the control group （X^2 = 3.88, 4.99, 3.95 respectively, all P 〈 0.05 ）. Conduslon The combination of transmetil with ursodeoxycholic acid can improve therapeutic effect for ICP and prognosis of the neonates, especially for those severe cases.

关 键 词：妊娠期肝内胆汁淤积症 治疗效果 新生儿 预后 

分 类 号：R575[医药卫生—消化系统] R714.146[医药卫生—内科学]