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目的:探讨丁二磺酸腺苷蛋氨酸联合熊去氧胆酸治疗妊娠期肝内胆汁淤积症的疗效和安全性。方法:80例妊娠期肝内胆汁淤积症患者随机分为对照组和观察组各40例。对照组在常规治疗基础上加用熊去氧胆酸0.25 g,po,bid;观察组在对照组基础上再加用丁二磺酸腺苷蛋氨酸1.0 g,po,bid。两组疗程均为7 d。对比两组患者的临床瘙痒症状、肝功能血清标记物水平、围产结局及新生儿健康程度。结果:观察组瘙痒的Riikonen评分改善程度优于对照组(P<0.05);治疗后,两组患者的各项肝功能指标如TB、ALT、AST等均有显著下降,观察组下降程度显著高于对照组(P<0.05);观察组患者新生儿窒息发生率和产后出血发生率的差异明显低于对照组(P<0.05或0.01)。结论:丁二磺酸腺苷蛋氨酸联合熊去氧胆酸治疗妊娠期肝内胆汁淤积症安全性高、疗效确切。
Objective: To investigate the efficacy and safety of adenosine methionine combined with ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy. Methods: 80 cases of intrahepatic cholestasis of pregnancy were randomly divided into control group and observation group of 40 cases. In the control group, ursodeoxycholic acid (0.25 g, po, bid) was added on the basis of conventional treatment. The observation group was given adenosine methionine succinate 1.0 g, po, bid on the basis of the control group. The two courses of treatment were 7 d. Clinical pruritus symptoms, liver function markers, perinatal outcomes, and neonatal health were compared between the two groups. Results: The Riikonen score of the pruritus group was better than that of the control group (P <0.05). After treatment, the indexes of hepatic function, such as TB, ALT, AST and so on, decreased significantly in the observation group and significantly decreased in the observation group (P <0.05). The incidence of neonatal asphyxia and postpartum hemorrhage in the observation group was significantly lower than that in the control group (P <0.05 or 0.01). Conclusion: Combination of adenosine methionine and ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy is safe and effective.