熊去氧胆酸治疗妊娠期肝内胆汁淤积症的临床疗效及对妊娠结局的影响  

Clinical effect of ursodeoxycholic acid in treatment of intrahepatic cholestasis of pregnancy and the impact on pregnancy outcomes

作　　者：谷小梅 

机构地区：[1]南京市大厂医院(东南大学附属中大医院江北院区),江苏南京210000

出　　处：《中国妇幼保健》2017年第23期5895-5897,共3页Maternal and Child Health Care of China

摘　　要：目的分析熊去氧胆酸(UDCA)对妊娠期肝内胆汁淤积症(ICP)的临床治疗效果及对妊娠结局的影响,为探究ICP最佳治疗方案提供临床参考。方法选取2015年1月-2016年12月间在该院就诊且确诊为ICP的患者100例,随机分为试验组(50例)和对照组(50例)。对照组的患者施以传统地塞米松联合磷酸肌酸钠治疗方案,试验组在此基础上辅以熊去氧胆酸,治疗4周后比较两组的治疗效果和妊娠结局。结果两组治疗前瘙痒评分比较,差异无统计学意义(P>0.05);治疗第3天和治疗第5天试验组瘙痒评分低于对照组,试验组症状缓解时间明显短于对照组(P<0.05);两组TBA、ALT、AST治疗后水平较治疗前均有明显下降(P均<0.05),且试验组的治疗后水平明显低于对照组治疗后水平(均P<0.05);试验组的剖宫产人数、胎儿窘迫人数、羊水粪染人数和围产儿死亡人数均低于对照组(均P<0.05);试验组孕妇产后出血量及孕妇分娩孕周也明显低于对照组(P<0.05),对照组新生儿Apgar评分低于试验组(P<0.05)。结论熊去氧胆酸对妊娠期肝内胆汁淤积症的治疗效果和其对妊娠结局的影响均优于传统治疗方法。Objective To analyze the clinical effect of ursodeoxycholic acid （UDCA） in treatment of intrahepatic cholestasis of preg- nancy （ICP） and the impact on pregnancy outcomes, provide clinical reference for researching optimal treatment method of ICP. Methods One hundred patients diagnosed as ICP definitely in the hospital from January 2015 to December 2016 were selected, then they were randomly divided into test group and control group, 50 patients in each group. The patients in control group were treated with traditional dexamethasone combined with creatine phosphate sodium, and the patients in test group were treated with UDCA based on traditional dexam- ethasone combined with creatine phosphate sodium. The curative effects and pregnancy outcomes in the two groups were compared after four weeks of treatment. Results There was no statistically significant difference in itching score before treatment between the two groups （ P〉 0. 05 ） . On the third day and the fifth day of treatment, itching scores in test group were statistically significantly lower than those in control group, the remission time of symptoms in test group was statistically significantly shorter than that in control group （P〈0. 05 ） . In the two groups, the levels of total bile acid （TBA）, alanine aminotransferase （ALT）, and aspartate aminotransferase （AST） after treatment were statistically significantly lower than those before treatment （all P〈0. 05 ） ; the levels of TBA, ALT, and AST after treatment in test group were statistically significantly lower than those in control group （all P〈0. 05 ） . The numbers of cases with cesarean section, fetal distress, amniotie fluid pollution, and perinatal death in test group were statistically significantly lower than those in control group （all P〈0. 05 ） . The amount of postpartum hemorrhage and gestational weeks in test group were statistically significantly lower than those in control group （ P〈 0. 05 ） . Neonatal Apgar score in control group was s

关 键 词：熊去氧胆酸 妊娠期肝内胆汁淤积症 疗效 妊娠结局 

分 类 号：R714.25[医药卫生—妇产科学]