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目的探讨思美泰联合熊去氧胆酸治疗ICP的疗效及针对不同妊娠期ICP的疗效区别。方法收集该院2013年6月-2014年12月收治ICP患者80例,按照ICP分级随机分为A组、B组和C组。A组采用思美泰治疗,B组采用熊去氧胆酸治疗,C组采用联合用药,比较3组患者实验室指标、瘙痒评分和妊娠结局,并比较C组在治疗妊娠中期和妊娠晚期患者的实验室指标和瘙痒评分的不同。结果 13组治疗前TBA和肝功能、瘙痒指数无明显差异,治疗后A组和B组这些指标和指数无明显差异,C组指标和指数改善优于A组和B组,差异具有统计学意义;23组在剖宫产、胎儿窘迫和羊水污染以及Apgar≤7分发生无明显差异,C组在产后出血量、孕周和新生儿体重方面优于A组和B组,差异明显;3C组妊娠中期和妊娠晚期患者治疗前TBA、TBIL、ALT、AST、瘙痒指数比较无明显差异;治疗后妊娠中期TBA、TBIL、ALT、AST、瘙痒指数方面优于妊娠晚期,比较具有统计学意义(P<0.05)。结论思美泰联合熊去氧胆酸治疗ICP对减低血清中的胆汁酸和减少及改善肝功能及延长孕周、增加新生儿体重有重要作用,且对妊娠中期患者的疗效更显著。
Objective To explore the efficacy of Smectite combined with ursodeoxycholic acid in the treatment of ICP and the difference in curative effect of different gestational ICP. Methods Totally 80 ICP patients admitted from June 2013 to December 2014 in our hospital were randomly divided into A group, B group and C group according to ICP grade. Group A was treated with Smectite, Group B with ursodeoxycholic acid, Group C with combination therapy, and laboratory parameters, pruritus scores and pregnancy outcomes were compared among the three groups. Patients in Group C were treated in the second trimester of pregnancy and in the third trimester of pregnancy The difference between the laboratory index and the itching score. Results There was no significant difference in TBA, liver function and pruritus index between the 13 groups before treatment, and there was no significant difference between the groups A and B after treatment. The indexes and indices in group C were better than those in group A and group B, the difference was statistically significant ; 23 groups in cesarean section, fetal distress and amniotic fluid contamination and Apgar ≤ 7 points there was no significant difference in group C in postpartum hemorrhage, gestational age and neonatal body weight better than A and B group, the difference was significant; 3C group There was no significant difference in TBA, TBIL, ALT, AST and pruritus index before treatment between the third trimester and the second trimester of pregnancy. The levels of TBA, TBIL, ALT, AST and pruritus in the second trimester were better than the third trimester in the third trimester <0.05). Conclusion Simetic combined with ursodeoxycholic acid treatment of ICP on the reduction of serum bile acid and reduce and improve liver function and prolong the gestational age, increase the weight of newborn has an important role, and the effect of mid-pregnancy more significant.