UDCA联合SAMe治疗慢性乙肝合并妊娠期ICP疗效及其不良妊娠结局影响因素分析  

Analysis of the efficacy of ursodesoxycholic acid combined with adenosylmethionine butanedisulfonate for treating pregnant women with chronic hepatitis B and intrahepatic cholestasis in pregnancy and the factors influencing the adverse pregnancy outcomes

作　　者：王改存 朱喜增[1] 闪海霞[1] WANG Gaicun;ZHU Xizeng;SHAN Haixia(Nanyang Central Hospital,Henan Province,473000)

机构地区：[1]河南省南阳市中心医院,473000

出　　处：《中国计划生育学杂志》2024年第4期784-787,共4页Chinese Journal of Family Planning

基　　金：2020年河南省医学科技攻关计划联合共建项目(LHGJ20200905)。

摘　　要：目的:探讨熊去氧胆酸(UDCA)联合丁二磺酸腺苷蛋氨酸(SAMe)治疗慢性乙肝合并妊娠期肝内胆汁淤积症(ICP)疗效及其不良妊娠结局影响因素。方法:选取2020年6月-2023年6月本院治疗的慢性乙肝合并妊娠期ICP患者86例,根据治疗方式分为联合组40例(UDCA联合SAMe治疗)和对照组46例(单药UDCA治疗),比较两组临床疗效,检测两组肝功能指标谷草转氨酶(AST)、谷丙转氨酶(ALT)、血清总胆红素(TBIL)并分析其对妊娠结局的影响。结果:治疗后临床总有效率联合组(92.5%)高于对照组(76.1%),肝功能相关指标两组均得到改善但联合组更佳(均P<0.05);两组不良反应发生率(5.0%、4.3%)无差异(P>0.05),不良妊娠结局发生率联合组(7.5%)低于对照组(23.9%)(P<0.05)。多因素logistic回归分析发现,肝功能指标ALT、AST、HbsAg升高均是慢性乙肝合并妊娠期ICP患者不良妊娠结局发生的独立危险因素(P<0.05)。结论:UDCA联合SAMe治疗慢性乙肝合并妊娠期ICP疗效提高,且未增加不良反应;ALT、AST、HbsAg升高均是慢性乙肝合并妊娠期ICP患者不良妊娠结局发生的危险因素。Objective:To investigate the efficacy of ursodesoxycholic acid(UDCA)combined with adenosylmethionine butanedisulfonate(SAMe)for treating pregnant women with chronic hepatitis Band intrahepatic cholestasis in preg-nancy(ICP),and to study the factors influencing the adverse pregnancy outcomes of the women.Methods:86 pregnant women with chronic hepatitis Band ICP were selected and were divided into two groups according to the different treatment methods from June 2020 to June 2023.40 women in the study group were treated with UDCA combined with SAMe,while 46 women in the control group were treated with single-agent UDCA.The clinical efficacy of the women was compared between the two groups.The levels of liver function indexes,such as aspartate aminotransferase(AST),alanine aminotransferase(ALT)and serum total bilirubin(TBIL),of the women in the two groups were detected,and the influence of which on the pregnancy outcomes of the women were analyzed.Results:The total clinical efficacy rate(92.5%)of the women in the study group was significantly higher than that(76.1%)of the women in the control group(P<0.05).The liver function-related indexes levels of the women in the two groups after treatment had improved significantly,and which of the women in the study group were significantly better than those of the women in the control group(all P<0.05).There was no significant difference in the incidence of the adverse reactions(5.0%vs.4.3%)of the women after treatment between the two groups(P>0.05).The incidence of the adverse pregnancy outcomes(7.5%)of the women in the study group was significantly lower than that(23.9%)of the women in the control group(P<0.05).Multivariate logistic regression analysis showed that the elevations of the levels of liver function indexes,such as ALT,AST and HbsAg,of the pregnant women with chronic hepatitis Band ICP were all the independent risk factors of their adverse cy outcomes(P<0.05).Conclusion:UDCA combined with SAMe for treating the pregnant women with chronic hepatitis Band ICP has be

关 键 词：慢性乙肝 妊娠期肝内胆汁淤积症 熊去氧胆酸 丁二磺酸腺苷蛋氨酸 临床疗效 不良妊娠结局 肝功能 影响因素 

分 类 号：R714.255[医药卫生—妇产科学]