腺苷蛋氨酸联合多烯磷脂酰胆碱治疗妊娠期肝内胆汁淤积症对孕妇内皮素表达及妊娠结局影响  

Effects of ademetionine combined with polyene phosphatidylcholine for treating women with intrahepatic cholestasis of pregnancy on the expression of endothelin and pregnancy outcomes

作　　者：云蕊 符映 符怡[1] YUN Rui;FU Ying;FU Yi(Wenchang People's Hospital,Wenchang,Hainan Province,571300)

机构地区：[1]海南省文昌市人民医院,571300

出　　处：《中国计划生育学杂志》2022年第10期2267-2271,共5页Chinese Journal of Family Planning

基　　金：海南自然科学基金面上项目(817403)。

摘　　要：目的:探究腺苷蛋氨酸联合多烯磷脂酰胆碱(PPC)治疗妊娠期肝内胆汁淤积症(ICP)效果,及对孕妇静脉血、脐血及胎盘组织内皮素(ET)表达和妊娠结局的影响.方法:选取2019年1月-2020年8月在本院接受ICP治疗的孕妇79例,随机数表法分为联合组(41例)和常规组(38例),分别采用腺苷蛋氨酸联合PPC治疗或常规治疗(口服熊去氧胆酸片),对比两组相关参数.结果:联合组治疗后第3、7、14d皮肤瘙痒评分(3.00±0.27分、2.26±0.19分、1.04±0.22分)均低于常规组(3.10±0.56分、2.84±0.61分、2.17±0.26分)(均P<0.05),血清内皮素-1(ET-1)、总胆汁酸、天门冬氨酸氨基转移酶、丙氨酸氨基转移酶浓度低于常规组,新生儿脐带血ET-1、胎盘组织ET-1表达评分均低于常规组(均P<0.05),并发羊水过多(2.4%)、产后出血发生率(2.4%)以及新生儿窘迫(2.4%)、早产率(2.4%)均低于常规组(21.1%、28.9%、18.4%、23.7%),经阴分娩率(51.2%)高于常规组(21.1%)(均P<0.05),两组妊娠高血压、羊水污染、胎盘前置、新生儿窒息和死亡发生率未见差异(P>0.05).结论:腺苷蛋氨酸联合PPC治疗ICP可降低孕妇静脉血、脐血及胎盘组织ET表达,显著改善临床症状及妊娠结局.Objective: To explore the therapeutic effects of ademetionine combined with polyene phosphatidylcholine(PPC)for treating pregnant women with intrahepatic cholestasis of pregnancy(ICP),and to study its influence on the expression of endothelin(ET)in venous blood,in cord blood,and in placental tissue,and the pregnancy outcomes of these women.Methods:A total of 79 pregnant women with ICP were selected and were divided into study group(41 cases)and control group(38 cases)by random number table method from January 2019 to August 2020.The women in the study group were treated by ademetionine combined with PPC,while the women in the control group were given conventional treatment.The related maternal and neonatal parameters values were compared between the two groups.Results:The scores of skin pruritus of the women on the 3rd,the 7th,and the 14d after treatment(3.00±0.27 points,2.26±0.19 points,and 1.04±0.22 points)in the study group were significantly lower than those(3.10±0.56 points,2.84±0.61 points,and 2.17±0.26 points)of the women in the control group(all P<0.05).The levels of serum endothelin-1(ET-1),total bile acid,aspartate aminotransferase,and alanine aminotransferase of the women in the study group were significantly lower than those of the women in the control group,and the expression levels of ET-1 in neonatal umbilical cord blood and placental tissue in the study group were also significantly lower than those in the control group(all P<0.05).The incidences of polyhydramnios(2.4%),postpartum hemorrhage(2.4%),neonatal distress(2.4%),and preterm birth(2.4%)in the study group were significantly lower than those(21.1%,28.9%,18.4%,and 23.7%)in the control group.The rate of vaginal delivery(51.2%)of the women in the study group was significantly higher than that(21.1%)of the women in the control group(all P<0.05).There were no significant differences in the incidences of gestational hypertension,amniotic fluid contamination,placenta previa,neonatal asphyxia,and neonatal death between the two groups(P>0.05).C

关 键 词：妊娠期肝内胆汁淤积症 腺苷蛋氨酸 多烯磷脂酰胆碱 内皮素 皮肤瘙痒 并发症 妊娠结局 

分 类 号：R714.255[医药卫生—妇产科学]