腺苷蛋氨酸联合熊去氧胆酸治疗妊娠期肝内胆汁淤积症患者的效果  

Effects of Ademetionine combined with Ursodeoxycholic acid in treatment of patients with intrahepatic cholestasis of pregnancy

作　　者：韩贝贝 翁玲玲 郭淑华 郑雪芹 HAN Beibei;WENG Lingling;GUO Shuhua;ZHENG Xueqin(Department of Obstetrics of Women&Infants Hospital of Zhengzhou,Zhengzhou 450000 Henan,China)

机构地区：[1]郑州市妇幼保健院产科,河南郑州450000

出　　处：《中国民康医学》2024年第4期94-96,100,共4页Medical Journal of Chinese People’s Health

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20230758)。

摘　　要：目的:观察腺苷蛋氨酸联合熊去氧胆酸治疗妊娠期肝内胆汁淤积症患者的效果。方法:选取2019年1月至2023年1月该院收治的76例妊娠期肝内胆汁淤积症患者进行前瞻性研究,按照随机数字表法将其分为研究组与对照组各38例。两组均予以基础治疗,在此基础上,对照组予以熊去氧胆酸治疗,研究组在对照组基础上联合腺苷蛋氨酸治疗,两组均治疗14 d。比较两组临床疗效,治疗前后肝功能指标[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆汁酸(TBA)]水平、瘙痒程度[四项目瘙痒量表(FIIQ)]评分、炎性因子[白细胞介素-12(IL-12)、白细胞介素-18(IL-18)、肿瘤坏死因子-α(TNF-α)]水平,不良反应发生率,以及不良母婴结局发生率。结果:研究组治疗总有效率为94.74%(36/38),高于对照组的78.95%(30/38),差异有统计学意义(P<0.05);治疗后,研究组ALT、AST、TBA水平均低于对照组,差异有统计学意义(P<0.05);治疗后,研究组FIIQ评分低于对照组,差异有统计学意义(P<0.05);治疗后,研究组IL-12、IL-18、TNF-α水平均低于对照组,差异有统计学意义(P<0.05);研究组不良母婴结局发生率为5.26%(2/38),低于对照组的23.68%(9/38),差异有统计学意义(P<0.05);两组治疗期间均未见明显不良反应。结论:腺苷蛋氨酸联合熊去氧胆酸治疗妊娠期肝内胆汁淤积症患者可提高治疗总有效率,降低肝功能指标水平、瘙痒程度评分、炎性因子水平和不良母婴结局发生率,效果优于单纯熊去氧胆酸治疗。Objective:To observe effects of Ademetionine combined with Ursodeoxycholic acid in treatment of patients with intrahepatic cholestasis of pregnancy.Methods:A prospective study was conducted on 76 patients with intrahepatic cholestasis of pregnancy admitted to the hospital from January 2019 to January 2023.According to the random number table method,they were divided into study group and control group,38 cases in each group.Both groups were given basic treatment.On this basis,the control group was treated with Ursodeoxycholic acid,while the study group was treated with Ademetionine on the basis of that of the control group.Both groups were treated for 14d.The clinical efficacy,the liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bile acid(TBA)]levels,the Itching degree[four-item itching questionnaire(FIIQ)]score,the inflammatory factors[interleukin-12(IL-12),interleukin-18(IL-18),tumor necrosis factor-α(TNF-α)]levels before and after the treatment,the incidence of adverse reactions,and the incidence of adverse maternal and infant outcomes were compared between the two groups.Results:The total effective rate of the study group was 94.74%(36/38),which was higher than 78.95%(30/38)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of ALT,AST and TBA in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the FIIQ score of the study group was lower than that of the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of IL-12,IL-18 and TNF-αin the study group were lower than those in the control group,the differences were statistically significant(P<0.05).The incidence of adverse maternal and infant outcomes in the study group was 5.26%(2/38),which was lower than 23.68%(9/38)in the control group,and the difference was statistically significant(P<0.05).However,there were no obvious adve

关 键 词：妊娠期肝内胆汁淤积症 腺苷蛋氨酸 熊去氧胆酸 肝功能 瘙痒 炎性因子 不良母婴结局 

分 类 号：R714.25[医药卫生—妇产科学]