熊去氧胆酸联用思美泰对妊娠期肝内胆汁淤积症患者生化指标及瘙痒程度的影响

目的 分析熊去氧胆酸联用思美泰对妊娠期肝内胆汁淤积症（ICP）患者生化指标及瘙痒程度的影响.方法 选择医院ICP患者129例,随机均分为3组,分别给予熊去氧胆酸、思美泰单用及联合使用,比较其肝脏相关生化指标、瘙痒评分及缓解时间、妊娠结局等情况.结果 联合用药组患者治疗后丙氨酸氨基转移酶（46.12±14.25）U/L,天门冬酸氨基转移酶（43.18±11.25）U/L,总胆汁酸（12.04±4.92）μmol/L,总胆红素（13.29±3.84）μmol/L,平均瘙痒评分（2.01±0.54）分,平均瘙痒缓解时间（3.13±0.74）d,妊娠不良结局发生率2.33％,均明显低于对照组;联合用药组的平均结束妊娠孕周（37.04±1.23）周,明显长于单独用药组（P＜0.05）.结论 熊去氧胆酸联用思美泰可有效改善ICP患者的肝功能指标,缓解瘙痒程度,改善妊娠结局,具有积极的临床意义.

Effect of Ursodeoxycholic Acid Combined Transmetil on Biochemical Indices and the degree of itching in Patients with Intrahepatic Cholestasis of Pregnancy

Objective To analyze the effect of Ursodeoxycholic acid and Transmetil on biochemical indices and the degree of itching in patients with intrahepatic cholestasis of pregnancy. Methods 129 patients with intrahepatic cholestasis of pregnancy were admitted to hospital were randomly divided into 3 groups which given ursodeoxycholic acid,Transmetil alone or in combination respectively,to compare their liver-related biochemical parameters, pruritus score and mitigation time, pregnancy outcome. Results Combination group ALT （46. 12 ± 14.25）U/L, AST （43.18 ± 11.25）U/L,TBA （12.04 ±4.92）lxmol/L,TB （13.29 ±3.84）umol/L, pruritus score （2.01 ±0. 54）, itching remission time（3.13 ±0.74）d, incidence of adverse pregnancy outcomes （2.33%） were significantly lower than the control group; Combination group average end the pregnancy gestational age （37.04±1.23） was significantly longer than medication alone group（ P 〈 0. 05 ）. Conclusion The ursodeoxycholic acid combined transmetil can effectively improve intrahepatic cholestasis of pregnancy in patients with liver function,relieve itching situation to improve pregnancy outcomes ,with positive clinical significance.