熊去氧胆酸及丁二磺酸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临床观察  

Clinical Observation of Ursodeoxycholic Acid and Succinylmethionine Combined with Polyene Phosphatidylcholine in the Treatment of Intrahepatic Cholestasis of Pregnancy

作　　者：姚杰[1] 王枫 YAO Jie;WANG Feng(The Fifth People's Hospital of Suzhou,Suzhou,Jiangsu,China 215000;Canglang New City Community Health Service Center of Wumenqiao Street in Gusu District,Suzhou,Jiangsu,China 215000)

机构地区：[1]江苏省苏州市第五人民医院,江苏苏州215000 [2]江苏省苏州市姑苏区吴门桥街道沧浪新城社区卫生服务中心,江苏苏州215000

出　　处：《中国药业》2023年第S01期55-57,共3页China Pharmaceuticals

摘　　要：目的探讨熊去氧胆酸及丁二磺酸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的临床疗效。方法选取医院2019年1月至2020年12月收治的妊娠期肝内胆汁淤积患者116例,随机分为观察组和对照组,各58例。两组患者均予熊去氧胆酸胶囊口服,每次250 mg,每日3次,以及丁二硫酸腺苷酰胺甲胺酯注射液1 g,溶于250 mL 5%葡萄糖注射液静脉滴注,每日1次;观察组患者加用多烯磷脂酰胆碱注射液10 mL,溶于250 mL 5%葡萄糖注射液静脉滴注,每日1次。两组均持续治疗14 d。结果观察组临床总有效率为96.55%,显著高于对照组的84.48%(P<0.05)。与对照组比较,观察组患者瘙痒消失时间和黄疸消失时间显著缩短(P<0.05);治疗前,两组患者丙氨酸氨基转移酶(ALT)、天门冬氨氨酸氨基转移酶(AST)、总胆红素(TBiL)和甘胆酸(CG)、总胆汁酸水平无显著差异(P>0.05);与对照组比较,观察组患者治疗后的AST,ALT,TBiL,CG及总胆汁酸水平显著降低(P<0.05)。观察组剖宫产、早产、羊水粪染、胎儿宫内窘迫发生率显著低于对照组(P<0.05)。结论熊去氧胆酸及丁二磺酸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,可改善患者的症状及肝功能指标,同时缩短瘙痒和黄疸消失的时间,改善妊娠结局。Objective To investigate the clinical efficacy of ursodeoxycholic acid and succinylmethionine combined with polyene phosphatidylcholine in the treatment of intrahepatic cholestasis of pregnancy.Methods A total of 116 patients with gestational intrahepatic cholestasis admitted to the hospital from January 2019 to December 2020 were randomly divided into the observation group and the control group,with 58 cases in each group.Both groups were given orally 250 mg of Ursodeoxycholic Acid Capsules(three times a day),1 g of Adenosine Disulfide Methylamine Succinate Injection dissolved in 250 mL of 5%glucose injection intravenously(once a day).On this basis,the observation group was given 10 mL of Polyene Phosphatidylcholine Injection,dissolved in 250 mL of 5%glucose injection,intravenous drip,once a day.Both groups were treated for 14 d.Results The total clinical effective rate in the observation group was 96.55%,which was significantly higher than 84.48%in the control group(P<0.05).Compared with those in the control group,the disappearance time of itching and jaundice in the observation group significantly shortened(P<0.05).Before treatment,there was no significant difference in the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBiL),glycyrrhetinic acid(CG),and total bile acid between the two groups(P>0.05).Compared with those in the control group,the levels of AST,ALT,TBiL,CG,and total bile acid in the observation group significantly reduced after treatment(P<0.05).The incidence of cesarean section,premature delivery,amniotic fluid fecal staining,and fetal distress in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Ursodeoxycholic acid and succinylmethionine combined with polyene phosphatidylcholine in the treatment of intrahepatic cholestasis of pregnancy can improve the symptoms and liver function indicators of patients,shorten the time for itching and jaundice to disappear,and improve pregnancy outcomes.

关 键 词：熊去氧胆酸 丁二磺酸腺苷蛋氨酸 多烯磷脂酰胆碱 妊娠期 肝内胆汁淤积症 

分 类 号：R969.4[医药卫生—药理学] R975.5[医药卫生—药学]