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目的:探讨腺苷蛋氨酸治疗妊娠期肝内胆汁淤积症的疗效。方法:妊娠期肝内胆汁淤积症孕妇48例随机分为观察组和对照组各24例。观察组给予腺苷蛋氨酸注射剂500mg加入5%葡萄糖注射液500mL中静脉滴注,1次/d;对照组给予能量合剂500mL静脉滴注,1次/d,疗程均为2周。比较2组皮肤瘙痒症状评分,谷丙转氨酶、谷草转氨酶、血清胆汁酸水平及妊娠结局(早产、胎儿窘迫、新生儿窒息、剖宫产、产后出血发生率)。结果:2组治疗后皮肤瘙痒症状评分、谷丙转氨酶、谷草转氨酶、血清胆汁酸水平均较治疗前下降(P<0.05),观察组较对照组下降明显(P<0.05)。观察组早产、胎儿窘迫、新生儿窒息的发生率低于对照组(P<0.05),剖宫产率、产后出血发生率比较差异无统计学意义(P>0.05)。结论:腺苷蛋氨酸可以改善妊娠期肝内胆汁淤积症患者瘙痒症状和妊娠结局,是治疗妊娠期肝内胆汁淤积症安全有效的药物。
Objective: To investigate the efficacy of adenosine methionine in the treatment of intrahepatic cholestasis of pregnancy. Methods: 48 cases of pregnant women with intrahepatic cholestasis of pregnancy were randomly divided into observation group and control group of 24 cases. The observation group was given adenosine methionine injection 500mg 5% glucose injection 500mL intravenous infusion, 1 / d; the control group was given 500ml of energy mixture intravenous infusion, 1 / d, the course of treatment were 2 weeks. The pruritus symptom score, alanine aminotransferase, aspartate aminotransferase, serum bile acid level and pregnancy outcome (preterm birth, fetal distress, neonatal asphyxia, cesarean section, postpartum hemorrhage incidence) were compared. Results: The scores of pruritus, alanine aminotransferase, aspartate aminotransferase and serum bile acid in the two groups were significantly lower than those before treatment (P <0.05). The observation group was significantly lower than the control group (P <0.05). The incidence of preterm birth, fetal distress and neonatal asphyxia in the observation group was lower than that in the control group (P <0.05). There was no significant difference in the incidence of cesarean section and postpartum hemorrhage (P> 0.05). Conclusion: Adenosine methionine can improve pruritus and pregnancy outcome in patients with intrahepatic cholestasis of pregnancy. It is a safe and effective drug for the treatment of intrahepatic cholestasis of pregnancy.