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目的:观察熊去氧胆酸(UDCA)联合S-腺苷蛋氨酸(SAMe)治疗重度妊娠期肝内胆汁淤积症(ICP)的临床疗效。方法:将40例重度ICP患者随机平均分为两组。治疗组予以口服UDCA,0.3 g/次,2次/d,同时静脉注射SAMe,1 g/次,1次/d,7天为一个疗程;对照组仅口服UDCA,0.3 g/次,2次/d,7天为一个疗程。观察并对比两组疗效。结果:联合用药后总胆红素(TBIL)、直接胆红素(DBIL)、总胆汁酸(TBA)、谷丙转氨酶(ALT)、谷草转氨酶(AST)水平及瘙痒评分明显下降,与对照组比较差异有统计学意义(P<0.05)。治疗组剖宫产率、羊水粪染率、胎儿窘迫和新生儿窒息发生率均下降,与对照组比较差异有统计学意义(P<0.05)。结论:联合应用VDCA和SAMe比单纯应用UDCA治疗重度ICP的疗效更好。
Objective: To observe the clinical efficacy of ursodeoxycholic acid (UDCA) and S-adenosylmethionine (SAMe) in the treatment of severe intrahepatic cholestasis of intestine (ICP). Methods: 40 severe ICP patients were randomly divided into two groups. The treatment group was given oral UDCA 0.3g / time, twice a day, while intravenous injection of SAMe, 1g / time, once / d, 7 days for a course of treatment; the control group only oral UDCA, 0.3g / time, twice / d, 7 days for a course of treatment. Observed and compared two groups of curative effect. Results: The levels of total bilirubin (TBIL), direct bilirubin (DBIL), total bile acid (TBA), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) The difference was statistically significant (P <0.05). Cesarean section rate, meconium-stained amniotic fluid, fetal distress and neonatal asphyxia in treatment group were decreased, which were significantly different from those in control group (P <0.05). Conclusion: The combination of VDCA and SAMe is more effective than UDCA alone in the treatment of severe ICP.