多烯磷脂酰胆碱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 Polyene phosphatidylcholine combined with Ursodeoxycholic acid in reatment of patients with intrahepatic cholestasis of pregnancy

作　　者：周晶云 华伟 ZHOU Jingyun;HUA Wei(Department of Obstetrics of the First Affiliated Hospital of Nanyang Medical College,Nanyang 473000 Henan,China)

机构地区：[1]南阳医学高等专科学校第一附属医院产科,河南南阳473000

出　　处：《中国民康医学》2025年第6期57-60,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察多烯磷脂酰胆碱联合熊去氧胆酸治疗妊娠期肝内胆汁淤积症(ICP)患者的效果。方法:回顾性分析2019-2023年该院收治的80例ICP患者的临床资料,按照治疗方式不同将其分为研究组与对照组各40例。对照组采用熊去氧胆酸治疗,研究组在对照组基础上联合多烯磷脂酰胆碱治疗。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)、天冬氨酸氨基转移酶(AST)、总胆红素]、血清学指标[总胆汁酸、胆碱酯酶、载脂蛋白AⅠ(APOAⅠ)]、炎性因子[白细胞介素-4(IL-4)、白细胞介素-12(IL-12)、白细胞介素-18(IL-18)]水平,不良母婴结局发生率,以及不良反应发生率。结果:研究组治疗总有效率为90.00%(36/40),高于对照组的70.00%(28/40),差异有统计学意义(P<0.05);治疗后,两组ALT、AST、总胆红素水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);治疗后,两组总胆汁酸水平均低于治疗前,且研究组低于对照组,两组胆碱酯酶、APOAⅠ水平均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);治疗后,两组IL-4水平均高于治疗前,且研究组高于对照组,两组IL-12、IL-18水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);研究组不良母婴结局发生率为30.00%(12/40),低于对照组的57.50%(23/40),差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:多烯磷脂酰胆碱联合熊去氧胆酸治疗ICP患者可提高治疗总有效率,改善血清学指标水平和炎性因子水平,以及降低肝功能指标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 Polyene phosphatidylcholine combined with Ursodeoxycholic acid in treatment of patients with intrahepatic cholestasis of pregnancy(ICP).Methods:The clinical data of 80 patients with ICP admitted to the hospital from 2019 to 2023 were retrospectively analyzed.They were divided into study group and control group according to different treatment methods,40 cases each.The control group was treated with Ursodeoxycholic acid,while the study group was treated with Polyene phosphatidylcholine on the basis of that of the control group.The clinical efficacy,the levels of liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin],serological indexes[total bile acid,cholinesterase,apolipoprotein AI(APOA I)]and inflammatory factors[interleukin-4(IL-4),interleukin-12(IL-12),interleukin-18(IL-18)]levels before and after the treatment,the incidence of adverse maternal and infant outcomes,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of treatment in the study group was 90.00%(36/40),which was higher than 70.00%(28/40)in the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of ALT,AST and total bilirubin in the two groups were lower than those before the treatment,those 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 total bile acid levels of the two groups were lower than those before the treatment,and that in the study group was lower than that in the control group;the levels of cholinesterase and APOA I in the two groups were higher than those before the treatment,and those in the study group were higher than those in the control group;and the differences were statistically significant(P<0.05).After the treatment,the levels of IL-4 in the two groups were higher than those before the treatment,and that in the study group was higher than that in th

关 键 词：熊去氧胆酸 多烯磷脂酰胆碱 妊娠期肝内胆汁淤积症 炎性因子 肝功能 不良母婴结局 

分 类 号：R714.25[医药卫生—妇产科学]