丁二磺酸腺苷蛋氨酸联合复方甘草酸苷对妊娠期肝内胆汁淤积症患者新生儿结局的影响及疗效观察  

Influence of adenosyl methionine combined with compound glycyrrhizin on neonatal outcome in patients with intrahepatic cholestasis of pregnancy and its curative effect

作　　者：施锦梅 应柳青 潘丹[1] SHI Jinmei;YING Liuqing;PAN Dan(Department of Gynecology,Taizhou 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

出　　处：《中国现代医生》2020年第3期50-53,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2019RC312)。

摘　　要：目的探讨丁二磺酸腺苷蛋氨酸联合复方甘草酸苷对妊娠期肝内胆汁淤积症(ICP)患者新生儿结局的影响及疗效。方法选取2016年7月~2018年7月在我院就诊的ICP患者90例,随机分为观察组和对照组。对照组给予复方甘草酸苷针200 mg/次,静脉注射,1次/d。观察组在此基础上联合丁二磺酸腺苷蛋氨酸针1000 mg/次,静脉注射,1次/d,两组均治疗3周。观察两组治疗前后血清内皮生长因子(VEGF)和γ-干扰素(IFN-γ)水平,并比较其临床疗效及新生儿结局。结果治疗3周后,两组血清VEGF水平均较治疗前明显升高,IFN-γ水平均较治疗前明显下降(P<0.05),且观察组变化幅度大于对照组(P<0.05);观察组临床总有效率高于对照组(P<0.05),观察组早产率、胎儿宫内窘迫率及新生儿窒息率均低于对照组(P<0.05)。结论丁二磺酸腺苷蛋氨酸联合复方甘草酸苷治疗ICP疗效确切,能减少新生儿不良结局的发生,作用机制可能与其能升高血清VEGF水平,降低血清IFN-γ水平相关。Objective To investigate the influence and efficacy of adenosine succinate combined with glycyrrhizin on neonatal outcomes in patients with intrahepatic cholestasis of pregnancy(ICP). Methods 90 patients with ICP who visited our hospital from July 2016 to July 2018 were randomly divided into observation group and control group. The control group was given compound glycyrrhizin 200 mg/time, intravenously, once a day. On the basis of above treatment,the observation group was combined with the adenosyl methionine needle 1000 mg/time, intravenously, once a day, and both groups were treated for 3 weeks. The levels of serum endothelial growth factor(VEGF) and γ-interferon(IFN-γ)were measured before and after treatment in both groups, and the clinical efficacy and neonatal outcome were compared. Results After 3 weeks of treatment, serum VEGF levels in two groups were significantly higher than those before treatment, and IFN-γ levels were significantly lower than those before treatment(P<0.05). And the change magnitude of the observation group was larger than that of the control group(P<0.05). The total clinical effective rate of the observation group was higher than that of the control group(P<0.05). The preterm birth rate, intrauterine distress rate and neonatal asphyxia rate was lower in the observation group than that in the control group(P<0.05). Conclusion The adenosyl methionine and compound glycyrrhizin in the treatment of ICP is effective and can reduce the adverse outcomes in neonates. The mechanism may be related to the increase of serum VEGF level and the decrease of serum IFN-γ level.

关 键 词：妊娠期肝内胆汁淤积症 丁二磺酸腺苷蛋氨酸 复方甘草酸苷 新生儿结局 

分 类 号：R714.255[医药卫生—妇产科学]