S-腺苷蛋氨酸联合利胆药对妊娠期肝内胆汁淤积症的疗效分析  

Effect of S-adenosylmethionine combined with cholagogic tablets on intrahepatic cholestasis of pregnancy

作　　者：倪惠华[1] 晓霄[1] 李娟[1] 张玉泉[1] Hui-hua Ni;Xiao Xiao;Juan Li;Yu-quan Zhang(Department of Obstetrics and Gynecology;Hospital Affiliated to Nantong University;Nantong,Jiangsu 226001,China)

机构地区：[1]南通大学附属医院妇产科,江苏南通226001

出　　处：《中国现代医学杂志》2018年第26期100-103,共4页China Journal of Modern Medicine

摘　　要：目的分析S-腺苷蛋氨酸联合利胆药对妊娠期肝内胆汁淤积症产妇胎盘组织中NF-κB相关因子表达水平及Th17/Treg平衡的影响。方法选取2012年12月-2016年12月于南通大学附属医院妇收治的96例妊娠期肝内胆汁淤积症产妇,并按随机数字表法分为对照组和观察组。对照组采用利胆药进行治疗;观察组采用S-腺苷蛋氨酸联合利胆药治疗。对比两组患者瘙痒症状评分、TNF-α、HIF-1α、TGF-β1、总胆汁酸(TBA)及IL-17的含量,并分析患者Th17、Treg细胞相对数及Th17/Treg的变化情况。结果两组患者血清中TNF-α、HIF-1α、TGF-β1、TBA及IL-17比较有差异(P<0.05)。两组患者瘙痒症状评分、Th17、Treg细胞相对数及Th17/Treg比率比较有差异(P<0.05)。两组患者治疗的总有效率比较有差异(P<0.05)。两组患者早产率、胎儿宫内窘迫率及新生儿窒息率比较有差异(P<0.05)。结论采用S-腺苷蛋氨酸联合利胆药治疗妊娠期肝内胆汁淤积症产妇,能有效改善患者NF-κB相关因子表达水平及Th17/Treg平衡,缓解患者的瘙痒症状,减少新生儿不良反应的发生。Objective To analyze the influence of S-adenosylmethionine combined with cholagogues on the the balance of of NF-κB-related factors and Th17/Treg in placenta in pregnant women with intrahepatic cholestasis.Methods Ninety-six cases of intrahepatic cholestasis of pregnancy in our hospital from December 2012 to December 2016 were selected,and randomly divided into a control group and an observation group,each group had 48 cases.The patients in the control group were treated with cholagogues;those in the observation group were treated with S-adenosylmethionine combined with cholagogues.The pruritus score,and the content of TNF-α,HIF-1α,TGF-β1,TBA and IL-17 were compared and analyzed,and the changes of Th17,Treg cells and the ratio of Th17/Treg were analyzed.Results The serum levels of TNF-α,HIF-1α,TGF-β1,TBA and IL-17 were significantly different between the two groups(P<0.05).The score of pruritus symptom,the relative numbers of Th17 and Treg cells and the ratio of Th17/Treg were significantly different between the two groups(P<0.05).The total effective rates of the two groups were significantly different(P<0.05).The incidences of preterm birth,fetal distress and neonatal asphyxia were significantly different between the observation group and the control group(P<0.05).Conclusions S-adenosylmethionine combined with cholagogues for treatment of intrahepatic cholestasis in pregnant women could effectively improve the the balance of NF-κB-related factors and Th17/Treg in the patients,relieved itching,and reduce the incidences of neonatal adverse reactions.

关 键 词：S-腺苷蛋氨酸 利胆药 妊娠期肝内胆汁淤积症 

分 类 号：R714.2[医药卫生—妇产科学]