论文部分内容阅读
目的探讨熊去氧胆酸与多烯磷脂酰胆碱联合用药治疗妊娠期肝内胆汁淤积症(ICP)的临床疗效,以期为临床治疗用药提供参考。方法选取该院2016年1月-2017年1月收治的ICP患者103例,随机分为对照组(51例)与观察组(52例),分别采用单纯的熊去氧胆酸和熊去氧胆酸与多烯磷脂酰胆碱治疗,观察患者治疗前后临床症状变化和生化指标变化,比较两组患者分娩孕周、分娩方式及产妇与胎儿并发症。结果经治疗后,两组的瘙痒评分均明显降低(P<0.05),且观察组明显低于对照组(P<0.05);与对照组相比,观察组瘙痒消失时间和黄疸消失时间均明显缩短(P<0.05)。经治疗后,两组患者血清胆汁酸(TBA)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)均有所下降,与治疗前相比,差异均有统计学意义(P<0.05);治疗后观察组TBA、AST、ALT值明显低于对照组(P<0.05),但治疗前两组间TBA、AST、ALT比较,差异均无统计学意义(P>0.05)。与对照组相比,观察组分娩孕周延长,剖宫产率、早产率及产后出血率降低,出生体质量增加,且差异均有统计学意义(P<0.05)。但两组间Apgar评分、新生儿窒息率、住院时间、围生儿死亡率、羊水污染率比较,差异均无统计学意义(均P>0.05)。结论熊去氧胆酸与多烯磷脂酰胆碱联合用药能够缓解ICP患者瘙痒、黄疸等临床症状,改善各项生化指标,减少产妇与胎儿并发症的发生,优化妊娠结局。
Objective To investigate the clinical efficacy of ursodeoxycholic acid combined with polyene phosphatidylcholine in the treatment of intrahepatic cholestasis of pregnancy (ICP), in order to provide reference for clinical treatment. Methods A total of 103 ICP patients admitted to our hospital from January 2016 to January 2017 were randomly divided into control group (n = 51) and observation group (n = 52). Ursodeoxycholic acid and ursodeoxycholic acid Cholic acid and polyene phosphatidylcholine treatment, changes in patients with clinical symptoms before and after treatment and changes in biochemical indicators were compared gestational age, delivery mode and maternal and fetal complications in both groups. Results After treatment, the pruritus scores of both groups were significantly decreased (P <0.05), and the observation group was significantly lower than the control group (P <0.05); compared with the control group, the disappearance of itching time and the disappearance of jaundice Shortened (P <0.05). After treatment, the levels of serum bile acid (TBA), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) decreased in both groups, with statistical difference (P <0.05). After treatment, the levels of TBA, AST and ALT in the observation group were significantly lower than those in the control group (P <0.05), but there was no significant difference in the levels of TBA, AST and ALT between the two groups before treatment 0.05). Compared with the control group, the observation group delivered gestational weeks prolonged, cesarean section rate, premature delivery rate and postpartum hemorrhage rate decreased, birth weight increased, and the differences were statistically significant (P <0.05). However, Apgar score, neonatal asphyxia, hospital stay, perinatal mortality and amniotic fluid contamination rates were not significantly different between the two groups (all P> 0.05). Conclusion The combination of ursodeoxycholic acid and polyene phosphatidylcholine can relieve the clinical symptoms such as pruritus and jaundice in ICP patients, improve various biochemical indexes, reduce the incidence of maternal and fetal complications and optimize the pregnancy outcome.