| 蒋静文,陈嘉丽,邬瑞霞,陈历英,邹茂贤.熊去氧胆酸联用思美泰对妊娠期肝内胆汁淤积症重症患者瘙痒程度、妊娠结局及肝功能的影响[J].,2019,19(6):1168-1171 |
| 熊去氧胆酸联用思美泰对妊娠期肝内胆汁淤积症重症患者瘙痒程度、妊娠结局及肝功能的影响 |
| The Effects of Ursodeoxycholic Acid Combined with Transmetil on Pruritus,Pregnancy Outcome and Liver Function in Patients with Severe Intrahepatic Cholestasis of Pregnancy |
| 投稿时间：2018-09-08 修订日期：2018-09-30 |
| DOI：10.13241/j.cnki.pmb.2019.06.037 |
| 中文关键词: 妊娠期肝内胆汁淤积症 熊去氧胆酸 思美泰 瘙痒程度 妊娠结局 肝功能 |
| 英文关键词: Intrahepatic cholestasis of pregnancy Ursodeoxycholic acid Transmetil Itching degree Pregnancy outcome Liver function |
| 基金项目:广东省科技计划项目（2016A0216321） |
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| 中文摘要: |
| 摘要 目的：探讨熊去氧胆酸联用思美泰对妊娠期肝内胆汁淤积症（ICP）重症患者瘙痒程度、妊娠结局及肝功能的影响。方法：选取2016年6月到2017年12月期间在我院接受治疗的ICP重症患者76例，根据随机数字表法将患者均分为研究组（n=38）和对照组（n=38）。对照组采用熊去氧胆酸进行治疗，研究组采用熊去氧胆酸联用思美泰进行治疗。比较两组患者治疗前、治疗7d后的Ribaha皮肤瘙痒程度评分、天冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）、总胆汁酸（TBA）、血清总胆红素（TB）的水平，比较两组患者的妊娠结局。结果：治疗7d后两组患者的瘙痒程度评分均明显降低，且研究组低于对照组（P<0.05）。治疗7d后两组患者的AST、ALT、TBA、TB水平均明显降低，且研究组患者的AST、ALT、TBA、TB水平低于对照组，差异有统计学意义（P<0.05）。两组患者的新生儿窒息发生率和新生儿体质量比较无统计学差异（P>0.05），研究组患者早产、胎儿窘迫、羊水胎粪污染的发生率低于对照组，差异有统计学意义（P<0.05）。结论：熊去氧胆酸联用思美泰可有效缓解ICP重症患者的瘙痒程度，改善肝功能和妊娠结局，临床疗效显著，具有积极的临床意义。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of ursodeoxycholic acid combined with transmetil on the itching degree,pregnancy outcome and liver function in patients with severe intrahepatic cholestasis of pregnancy (ICP). Methods: 76 patients with severe ICP who were treated in our hospital from June 2016 to December 2017 were enrolled. The patients were divided into study group （n=38） and control group（n=38） according to the random number table method. The control group was treated with ursodeoxycholic acid, and the study group was treated with ursodeoxycholic acid combined with transmetil. The levels of Ribaha skin itching degree score, aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bile acid (TBA), serum total bilirubin (TB) before treatment and 7 days after treatment were compared between the two groups. The pregnancy outcomes of the two groups were compared. Results: 7 days after treatment, the itching degree scores of the two groups were significantly lower, and the study group was lower than that of the control group(P<0.05). 7 days after treatment, the levels of AST, ALT, TBA and TB in the two groups were significantly lower, and the levels of AST, ALT, TBA and TB in the study group were lower than those in the control group, the difference was statistically significant (P<0.05). There was no significant difference between the two groups in the incidence of neonatal asphyxia and neonatal body mass (P>0.05). The incidence of premature labor, fetal distress and meconium stained amniotic fluid in the study group were lower than those in the control group, and the difference was statistically significant (P<0.05). Conclusion: The ursodeoxycholic acid combined with transmetil can effectively relieve itching degree in patients with severe ICP, and it can improve liver function and pregnancy outcomes, the clinical effect is significant, it has positive clinical significance. |
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