多烯磷脂酰胆碱联合谷胱甘肽治疗妊娠期肝内胆汁淤积症患者的效果及对围产结局的影响  

Effect of polyene phosphatidylcholine combined with glutathione on patients with intrahepatic cholestasis of pregnancy and its influence on perinatal outcome

作　　者：方芳[1] 潘丹[1] 蔡军波[2] FANG Fang;PAN Dan;CAI Junbo(Department of Gynecology,Taizhou Municipal Hospital in Zhejiang Province,Taizhou318000,China;Department of Oncological Surgery,Taizhou Municipal Hospital in Zhejiang Province,Taizhou318000,China)

机构地区：[1]浙江省台州市立医院妇科,浙江台州318000 [2]浙江省台州市立医院肿瘤外科,浙江台州318000

出　　处：《中国现代医生》2020年第2期16-19,共4页China Modern Doctor

基　　金：浙江省医药卫生科技项目(2019RC312)。

摘　　要：目的探讨多烯磷脂酰胆碱联合谷胱甘肽治疗妊娠期肝内胆汁淤积症(ICP)患者的效果及对围产结局的影响。方法选取2015年1月~2018年12月ICP患者124例,随机分为两组。两组均予以卧床休息、间断吸氧、高渗葡萄糖、维生素C及能量合剂等治疗。对照组在此基础上予以多烯磷脂酰胆碱针15 mL静脉滴注,1次/d;观察组在对照组基础上再加谷胱甘肽针2.4 g静脉滴注,1次/d。两组均连用2周。观察两组治疗后临床症状及血清生化指标改善情况,并比较其围产结局。结果治疗2周后,两组瘙痒评分均较治疗前显著下降(P<0.01或P<0.05),且观察组下降幅度较对照组更明显(P<0.05);观察组黄疸和瘙痒消失时间明显少于或短于对照组(P<0.05)。治疗2周后,两组血清ALT、TBA和AST水平均较治疗前明显下降(P<0.01或P<0.05),且观察组下降幅度较对照组更明显(P<0.05)。同时观察组宫内窘迫、早产和新生儿窒息发生率明显低于对照组,分娩出血量明显少于对照组,新生儿体重明显大于对照组(P<0.05)。结论多烯磷脂酰胆碱联合谷胱甘肽治疗ICP患者不仅能明显改善其临床症状,降低肝酶指标与胆汁酸水平,而且能降低发生不良围产结局,有利于母婴安全。Objective To investigate the effect of polyene phosphatidylcholine combined with glutathione on patients with intrahepatic cholestasis of pregnancy(ICP)and the influence of perinatal outcome.Methods A total of 124 patients with ICP from January 2015 to December 2018 were randomly divided into two groups.Both groups were treated with bed rest,intermittent oxygen,hypertonic glucose,vitamin C and energy mixture.On the basis of this,the control group was given an intravenous infusion of 15 ml of polyene phosphatidylcholine needle once a day.The observation group was treated with an intravenous infusion of 2.4 g of glutathione needle once a day based on the treatment of the control group.Both groups were used for 2 weeks.The improvement of clinical symptoms and serum biochemical parameters of two groups after treatment was observed,and the perinatal outcomes were compared.Results After 2 weeks of treatment,the pruritus scores of the two groups were significantly lower than those before(P<0.01 or P<0.05),and the decrease of the observation group was more significant than that of the control group(P<0.05).The disappearance time of jaundice and itching in the observation group was significantly less than or shorter than that of the control group(P<0.05).After 2 weeks of treatment,the serum levels of ALT,TBA and AST in the two groups were significantly lower than those before treatment(P<0.01 or P<0.05),and the decrease in the observation group was more significant than that in the control group(P<0.05).The incidence of distress,premature delivery and neonatal asphyxia in the observation group was significantly lower than that of the control group.The amount of bleeding after delivery in the observation group was significantly lower than that of the control group,and the weight of the newborn in the observation group was significantly higher than that of the control group(P<0.05).Conclusion Polyene phosphatidylcholine combined with glutathione in the treatment of ICP patients can not only significantly improve their clini

关 键 词：妊娠期肝内胆汁淤积症 多烯磷脂酰胆碱 谷胱甘肽 围产结局 

分 类 号：R714.255[医药卫生—妇产科学]