2017 年第 12 期 第 12 卷

熊去氧胆酸治疗妊娠期肝内胆汁淤积症的临床效果及对患者妊娠结局影响

作者：高琴张丹丹

英文作者：

单位：430081武汉市普仁医院武汉科技大学附属医院妇产科

英文单位：

关键词：肝内胆汁淤积症；熊去氧胆酸；妊娠结局

英文关键词：

• 摘要：

• 目的    观察熊去氧胆酸治疗妊娠期肝内胆汁淤积症的效果及对患者妊娠结局的影响。方法    选取2016年6—12月武汉市普仁医院妇产科收治的108例妊娠期肝内胆汁淤积症患者作为研究对象。按照随机数字表法分为对照组和观察组，各54例。对照组常规给予地塞米松磷酸钠注射液肌内注射连续治疗14 d，观察组在对照组基础上给予熊去氧胆酸胶囊口服连续治疗14 d，比较2组患者的临床疗效、血清生化指标、瘙痒症状评分和妊娠结局指标。结果    观察组治疗总有效率明显高于对照组［96.3%（52/54）比81.5%（44/54）］，差异有统计学意义(P<0.05)。治疗后观察组血清生化指标（丙氨酸转氨酶、天冬氨酸转氨酶、总胆红素、总胆汁酸、直接胆红素）和瘙痒症状评分均明显低于对照组［（30.1±2.2）U/L比（45.4±2.8）U/L、（27.5±2.2）U/L比（41.2±2.5）U/L、（18.2±2.0）μmol/L比（27.2±2.1）μmol/L、（1.77±0.23）μmol/L比（2.17±0.68）μmol/L、（9.8±1.1）μmol/L比（4.6±0.9）μmol/L、（1.08±0.15）分比（2.18±0.24）分］，观察组妊娠结局指标（妊娠期高血压、前置胎盘、剖宫产、胎儿窘迫、早产、胎膜早破、羊水过多、产后出血、泌尿感染、新生儿不良症）发生率均明显低于对照组，差异均有统计学意义(均P<0.05)。结论    熊去氧胆酸治疗妊娠期肝内胆汁淤积症临床效果肯定，在缓解患者瘙痒症状、改善肝功能和改善妊娠结局等方面具有明显的作用。

• Effect of ursodeoxycholic acid on intrahepatic cholestasis of pregnancy and pregancy outcome

  Gao Qin, Zhang Dandan

  Department of Obstetrics and Gynecology, Wuhan Puren Hospital, the Affiliated Hospital of Wuhan University of Science and Technology, Wuhan 430081, China

  Corresponding author: Gao Qin, Email： 982901309@qq.com

  【Abstract】Objective    To observe the effect of ursodeoxycholic acid on intrahepatic cholestasis of pregnancy and pregency outcome. Methods    Totally 108 patients with intrahepatic cholestasis of pregnancy admitted from June to December 2016 in Department of Obstetrics and Gynecology of Wuhan Puren Hospital were randomly divided into control group and observation group, with 54 cases in each group. The control group was treated with dexamethasone sodium phosphate intramuscular injection for 14 d; the observation group took ursodeoxycholic acid capsules for 14 d on the basis of control group. Clinical curative effect, serum biochemical indicators, score of pruritus and pregnancy outcome were analyzed. Results    The total effective rate in observation group was significantly higher than that in control group［96.3%（52/54） vs 81.5%（44/54）］（P＜0.05）. Levels of serum biochemical indicators（alanine aminotransferase, aspartate aminotransferase, total bilirubin, total bile acid and direct bilirubin） and score of pruritus after treatment in observation group were significantly lower than those in control group［（30.1±2.2）U/L vs （45.4±2.8）U/L, （27.5±2.2）U/L vs （41.2±2.5）U/L, （18.2±2.0）μmol/L vs （27.2±2.1）μmol/L, （1.77±0.23）μmol/L vs （2.17±0.68）μmol/L, （9.8±1.1）μmol/L vs （4.6±0.9）μmol/L, （1.08±0.15）points vs （2.18±0.24）points］（P＜0.05）. Incidences of pregnancy outcome events（gestational hypertension, placenta previa, cesarean section, fetal distress, premature delivery, premature rupture of fetal membranes, hydramnios, postpartum hemorrhage, urinary infection and deficiencies in newborn） in observation group were significantly lower than those in control group（P＜0.05）. Conclusion    Ursodeoxycholic acid treating intrahepatic cholestasis of pregnancy can relieve pruritus symptoms, improve liver function and improve pregnancy outcome.

  【Key words】Intrahepatic cholestasis of pregnancy;Ursodeoxycholic acid;Pregnancy outcome