妊娠肝内胆汁瘀积症的药物治疗

目的:观察熊去氧胆酸(UDCA)、地塞米松等药物治疗妊娠肝内胆汁瘀积症(ICP)的临床疗效.方法:117例患者随机分为3组,第1组采用护肝药综合治疗,第2组在综合治疗的基础上加用地塞米松10 mg,qd,疗程3 d,第3组在第2组用药基础上另加UDCA 100 mg,tid,疗程7～14 d.比较3组临床疗效,包括孕妇病情变化及围生儿结局.结果:第3组的显效率为58.6%,显著高于第1组和第2组,差异有极显著性(P＜0.01).第3组新生儿窒息的发生率为6.9%,显著低于第1,2组,差异有显著性(P＜0.05).结论:UDCA能有效降低ICP患者的肝酶和胆汁酸水平,同时还能降低新生儿窒息的发生率,改善围生儿的预后.

Drug Treatment in Intrahepatic Cholestasis of Pregnancy

Objective: To study the clinical effects of UDCA/dexamethesone in treating intrahepatic cholestasis of pregnancy (ICP). Methods: 117 patients were divided into three groups: group A received the general treatment with hepatoprotective drugs, group B was given extra treatment with dexamethesone, group C was received UDCA on the basis of treatment pattern of group B. clinical effects, including changes of maternal condition and perinatal outcomes, were evaluated among the three groups. Results:The effective rate in Group C was 58.6 % , It was significantly higher than those in group A and group B ( P < 0.01) . The rate of newborn asphyxia (Apgar score lower than 7) in group C was 6.9%, It was significantly lower than those in group A and group B ( P < 0. 05). Conclusion: The results of this study indicate that UDCA has a good therapeutical effect in reducing both the maternal serum liver enzymes and bile acids for ICP patients. Meanwhile it can also reduce the incidence of newborn asphyxia and improve the perinatal outcomes.