熊去氧胆酸联合思美泰对妊娠期肝内胆汁淤积症患者血清sICAM-1及CGRIA的影响  

Effects of Ursodeoxycholic Acid combined with Transmetil on serum sICAM-1 and CGRIA in Patients with Intrahepatic Cholestasis of Pregnancy

作　　者：邱敏玲[1] 邱洁玲 王玲 李维真[1] QIU Min-ling;QIU Jie-ling;WANG Ling(Obstetrics and Gynecology Department of Guangzhou Huadu Maternal and Child Henlth Hospital(Huzhong hospital),Guangzhou 510800,China)

机构地区：[1]广州市花都区妇幼保健院(胡忠医院)妇产科,广东广州510800

出　　处：《吉林医学》2021年第5期1099-1102,共4页Jilin Medical Journal

摘　　要：目的:熊去氧胆酸(ursodeoxycholic acid,UDCA)联合思美泰对妊娠期肝内胆汁淤积症(Intrahepatic cholestasis of pregnancy,ICP)患者血清可溶性细胞间黏附因子-1(soluble intercellular adhesion molecule-1,sICAM-1)及肝胆酸放射免疫分析(cholylglycine radioimmunoassay,CG RIA)的影响。方法:选取2016年1月~2020年2月就诊的500例妊娠期肝内胆汁淤积症患者,通过随机对照双盲法将其平均分为观察组250例,对照组250例,对照组采用熊去氧胆酸,观察组采用熊去氧胆酸联合思美泰。观察两组患者治疗前后血清总胆汁酸(Total bile acid,TBA)、总胆红素(total bilirubin,TB)、丙氨酸转氨酶(alanine aminotransferase,ALT)、门冬氨酸转氨酶(aspartate aminotransferase,AST)、血清sICAM-1及甘胆酸(cholylglycine,CG)水平,对比两组患者治疗前后的瘙痒程度和妊娠结局。结果:治疗前两组患者各检测指标差异无统计学意义(P>0.05);治疗后两组患者TBA、ALT、AST水平明显下降,差异有统计学意义(P<0.01),观察组明显优于对照组,差异有统计学意义(P<0.01);治疗后两组患者血清sICAM-1及CG RIA水平明显下降,差异有统计学意义(P<0.01),观察组明显低于对照组,差异有统计学意义(P<0.01);治疗前后两组瘙痒程度均较治疗前显著下降,观察组改善程度明显优于对照组,差异有统计学意义(P<0.01);观察组患者的不良妊娠结局均低于对照组,差异具有统计学意义(P<0.05)。结论:思美泰联合熊去氧胆酸能通过降低血清TBA、ALT、AST、sICAM-1、及CG RIA的水平,改善妊娠期肝内胆汁淤积症患者肝功能、皮肤瘙痒症状,同时减少不良妊娠结局的发生。Objective To study the effects of Ursodeoxycholic Acid combined with Transmetil on serum sICAM-1 and CG RIA in Patients with Intrahepatic Cholestasis of Pregnancy on the patients with Intrahepatic cholestasis of pregnancy(ICP).Method The clinical trial were assessed in a double-blinded randomized control design.500 patients with intrahepatic cholestasis of pregnancy admitted in our hospital from January 2016 to February 2020 were selected and randomly divided into the observation group 250 cases and control group 250 cases.The observation group was treated by ursodeoxycholic acid combined with transmetil while the control group was given ursodeoxycholic acid.The TBA(total bile acid),ALT(alanine aminotransferase),AST(aspartate aminotransferase),serum levels of soluble intercellular adhesion molecule-1(sICAM-1)and cholylglycine radioimmunoassay(CG RIA)was observed before and after the treatment between two groups.The degree of pruritus and pregnancy outcome were also assessed.Results No significant difference was observed in all markers between the two groups before treatments(P>0.05).After treatment,the levels of TBA,ALT,AST,serum sicam-1 and CG RIA in the two groups decreased significantly(P<0.01),and the observation group was significantly better than the control group(P<0.01).The itch degree of the two groups before and after treatment decreased significantly compared with that before treatment,and the improvement degree of the observation group was significantly better than that of the control group(P<0.01).The adverse pregnancy outcomes in the observation group were all lower than those in the control group,with statistical significance(P<0.05).Conclusion Transmetil combined ursodeoxycholic acid could effectively improve the liver function and skin pruritus and reduce the occurrence of adverse pregnancy outcomes of patients with intrahepatic cholestasis during pregnancy by reducing the levels of serum TBA,ALT,AST,sicam-1 and CG RIA.

关 键 词：熊去氧胆酸 思美泰 妊娠期肝内胆汁淤积症 SICAM-1 CG RIA 

分 类 号：R714.255[医药卫生—妇产科学]