熊去氧胆酸联合谷胱甘肽治疗妊娠期肝内胆汁淤积症的临床疗效
Clinical Effect of Ursodeoxycholic Acid combined with Glutathione in the Treatment of Intrahepatic Cholestasis of Pregnancy
沈丹 1王平1
作者信息
- 1. 南通市妇幼保健院急诊医学科,江苏南通 226018
- 折叠
摘要
目的 探讨熊去氧胆酸联合谷胱甘肽治疗妊娠期肝内胆汁淤积症(ICP)的临床疗效.方法 选取 2019 年 1 月至2022 年 12 月南通市妇幼保健院收治的 73 例ICP患者作为研究对象,并按入院顺序将其分为对照组(2019 年 1 月至 2021年 10 月就诊的 38 例患者)和观察组(2021 年 11 月至 2022 年 12 月就诊的 35 例患者).对照组给予熊去氧胆酸片治疗,观察组联合谷胱甘肽治疗.比较两组临床疗效、瘙痒症状、肝功能及妊娠结局.结果 观察组治疗有效率高于对照组,差异有统计学意义(P＜0.05);治疗后,观察组瘙痒评分低于对照组,差异有统计学意义(P＜0.05);治疗后,两组总胆汁酸(TBA)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBiL)水平较治疗前明显下降(P＜0.05),但观察组指标较对照组更低(P＜0.05);观察组剖宫产、早产、胎儿窘迫及新生儿Apgar评分＜7 分发生率低于对照组(P＜0.05),两组产后出血发生率比较差异无统计学意义(P＞0.05).结论 熊去氧胆酸联合谷胱甘肽治疗 ICP 的临床疗效较单一熊去氧胆酸治疗效果更佳,可以明显改善患者瘙痒症状和肝功能,降低不良妊娠结局发生风险.
Abstract
Objective To explore the clinical effect of ursodeoxycholic acid combined with glutathione in the treatment of intrahepatic cholestasis of pregnancy(ICP).Methods 73 patients with ICP admitted to Nantong Maternal and Child Health Hospital from January 2019 to December 2022 were selected.They were divided into control group(38 patients from January 2019 to October 2021)and observation group(35 patients from November 2021 to December 2022)according to the order of admission.The control group was treated with ursodeoxycholic acid tablets,and the observation group was treated with glutathione combined with ursodeoxycholic acid.The clinical efficacy,pruritus symptoms,liver function and pregnancy outcome were compared between the two groups.Results The effective rate of treatment in the observation group was higher than that in the control group,the difference was statistically significant(P＜0.05).After treatment,the itch score of the observation group was lower than that of the control group,and the difference was statistically significant(P＜0.05).After treatment,the levels of total bile acid(TBA),alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBiL)in 2 groups were significantly decreased compared with before treatment(P＜0.05),but the indexes in observation group were lower than those in control group(P＜0.05).The incidence of cesarean section,premature delivery,fetal distress and Apgar score＜7 in the observation group was lower than that in the control group(P＜0.05),and there was no significant difference in the incidence of postpartum hemorrhage between the two groups(P＞0.05).Conclusion Ursodeoxycholic acid combined with glutathione in the treatment of ICP has better clinical efficacy than that of ursodeoxycholic acid alone,which can significantly relieve pruritus and improve liver function,and reduce the risk of adverse pregnancy outcomes.
关键词
妊娠期肝内胆汁淤积症/熊去氧胆酸/谷胱甘肽Key words
Intrahepatic cholestasis of pregnancy/Ursodeoxycholic acid/Glutathione引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据