摘要
目的 探究熊去氧胆酸胶囊口服联合腺苷蛋氨酸静脉滴注对妊娠期肝内胆汁淤积症患者的疗效.方法 105 例妊娠期肝内胆汁淤积症患者,按照随机数字表法分为对照组(52 例)与观察组(53 例).对照组单用熊去氧胆酸胶囊口服治疗,观察组联用熊去氧胆酸胶囊口服、腺苷蛋氨酸静脉滴注治疗.比较两组患者的治疗效果、肝功能指标[谷氨酸氨基转移酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、直接胆红素(DBIL)、总胆红素(TBIL)、血清总胆汁酸(TBA)]、不良妊娠结局发生情况.结果 观察组治疗总有效率 98.11%高于对照组的 76.92%(P<0.05).治疗 2 周后,观察组ALT、AST、ALP、DBIL、TBIL、TBA分别为(82.34±10.56)U/L、(103.12±10.16)U/L、(51.23±8.54)U/L、(6.14±1.43)μmol/L、(18.23±3.24)μmol/L、(18.79±3.65)μmol/L,低于对照组的(128.56±13.27)U/L、(156.43±13.19)U/L、(89.96±9.67)U/L、(9.68±1.62)μmol/L、(24.05±3.78)μmol/L、(29.94±4.37)μmol/L(P<0.05);治疗 2 周后,两组ALT、AST、ALP、DBIL、TBIL、TBA低于治疗前(P<0.05).观察组不良妊娠结局发生率 5.66%低于对照组的 23.08%(P<0.05).结论 妊娠期肝内胆汁淤积症联用熊去氧胆酸胶囊口服、腺苷蛋氨酸静脉滴注治疗,可提高治疗效果,改善肝功能指标与母婴妊娠结局,值得临床推广.
Abstract
Objective To explore the efficacy of ursodeoxycholic acid capsules combined with ademetionine intravenous infusion on patients with intrahepatic cholestasis of pregnancy.Methods 105 patients with intrahepatic cholestasis of pregnancy were grouped into a control group(52 cases)and an observation group(53 cases)according to random number table method.Patients in the control group were treated with ursodeoxycholic acid capsules orally,and patients in the observation group were treated with ursodeoxycholic acid capsules orally and adenosine methionine intravenously.The therapeutic effect,liver function index[alanine aminotrasferase(ALT),aspartate transaminase(AST),alkaline phosphatase(ALP),direct bilirubin(DBIL),total bilirubin(TBIL),total bile acid(TBA)]and adverse pregnancy outcome were compared between the two groups.Results The total effective rate of the observation group was 98.11%,which was higher than 76.92%of the control group(P<0.05).After 2 weeks of treatment,ALT,AST,ALP,DBIL,TBIL and TBA in the observation group were(82.34±10.56)U/L,(103.12±10.16)U/L,(51.23±8.54)U/L,(6.14±1.43)μmol/L,(18.23±3.24)μmol/L and(18.79±3.65)μmol/L,which were lower than(128.56±13.27)U/L,(156.43±13.19)U/L,(89.96±9.67)U/L,(9.68±1.62)μmol/L,(24.05±3.78)μmol/L and(29.94±4.37)μmol/L in the control group(P<0.05).After 2 weeks of treatment,ALT,AST,ALP,DBIL,TBIL and TBA in both groups were lower than those before treatment(P<0.05).The incidence of adverse pregnancy outcome in the observation group was 5.66%,which was lower than 23.08%in the control group(P<0.05).Conclusion Ursodeoxycholic acid capsules combined with ademetionine intravenous infusion for the treatment of intrahepatic cholestasis of pregnancy can improve the therapeutic effect,liver function indexes and maternal and infant pregnancy outcomes,and is worthy of clinical promotion.
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