熊去氧胆酸、腺苷蛋氨酸联合多烯磷脂酰胆碱对妊娠期肝内胆汁淤积症患者相关指标的影响
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篇名: 熊去氧胆酸、腺苷蛋氨酸联合多烯磷脂酰胆碱对妊娠期肝内胆汁淤积症患者相关指标的影响
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摘要: 目的:探讨熊去氧胆酸、腺苷蛋氨酸联合多烯磷脂酰胆碱对妊娠期肝内胆汁淤积症(ICP)患者相关指标的影响。方法: 回顾性分析90例ICP患者资料,按用药的不同分为对照组(45例)和观察组(45例)。对照组患者给予熊去氧胆酸片300 mg,口服,每日3次+注射用丁二磺酸腺苷蛋氨酸1 g,加入5%葡萄糖注射液250 mL中,静脉滴注,每日1次。观察组患者在对照组治疗的基础上给予多烯磷脂酰胆碱注射液15 mL,加入5%葡萄糖注射液250 mL中,静脉滴注,每日1次。两组疗程均为2周。观察两组患者治疗前后瘙痒评分、血清胆汁酸(TBA)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)水平,妊娠结局及不良反应发生情况。结果:治疗前,两组患者瘙痒评分和TBA、ALT、AST水平比较,差异均无统计学意义(P>0.05)。治疗后,两组患者瘙痒评分和TBA、ALT、AST水平均显著低于同组治疗前,且观察组显著低于对照组,差异均有统计学意义(P<0.05)。观察组患者剖宫产、早产、胎儿窘迫和羊水粪染发生率均显著低于对照组,差异均有统计学意义(P<0.05)。两组患者治疗期间均未见明显不良反应发生。结论:熊去氧胆酸、腺苷蛋氨酸联合多烯磷脂酰胆碱可有效改善ICP患者的瘙痒症状、肝功能及妊娠结局,且安全性较好。
ABSTRACT: OBJECTIVE: To explore the effects of ursodeoxycholic acid and adenosine methionine combined with polyene phosphatidylcholine on related indicators of pregnancy with intrahepatic cholestasis (ICP). METHODS: Medical information of 90 ICP female were analyzed retrospectively and divided into control group (45 cases) and observation group (45 cases) according to drug use. Control group was given Ursodeoxycholic acid tablet 300 mg orally, 3 times a day+Transmetil for injection 1 g added into 5% Glucose injection 250 mL intravenously, once a day. Observation group was additionally given Polyene phosphatidylcholine injection 15 mL added into 5% Glucose injection 250 mL intravenously, once a day, on the basis of control group. Treatment course of 2 groups lasted for 2 weeks. The itching score, the levels of serum total bile acid (TBA), ALT and AST, pregnancy outcome and the occurrence of ADR were observed in 2 groups before and after treatment. RESULTS: Before treatment, there was no statistical significance in itching score, the levels of TBA, ALT and AST between 2 groups (P>0.05). After treatment, itching score, the levels of TBA, ALT and AST in 2 groups were significantly lower than before treatment, and the observation group was significantly lower than the control group, with statistical significance (P<0.05). The cesarean section rate, premature birth rate, fetal distress rate and amniotic fluid rate of observation group were significantly lower than those of control group, with statistical significance (P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS: Ursodeoxycholic acid, ademetionine combined with polyene phosphatidylcholine can effectively alleviate itching symptoms, liver function and pregnancy outcome of ICP patients, with good safety.
期刊: 2017年第28卷第18期
作者: 曹杰,蔡艾杞,田立碧,王佳
AUTHORS: CAO Jie,CAI Aiqi,TIAN Libi,WANG Jia
关键字: 妊娠期;肝内胆汁淤积;多烯磷脂酰胆碱;熊去氧胆酸;腺苷蛋氨酸
KEYWORDS: Pregnancy; Intrahepatic cholestasis; Polyene phosphatidylcholine; Ursodeoxycholic acid; Ademetionine
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