熊去氧胆酸治疗妊娠期肝内胆汁淤积症患者疗效研究*

doi:10.3969/j.issn.1672-5069.2019.06.022

实用肝脏病杂志 ›› 2019, Vol. 22 ›› Issue (6): 864-867.doi: 10.3969/j.issn.1672-5069.2019.06.022

• 妊娠期肝内胆汁淤积症 • 上一篇下一篇

熊去氧胆酸治疗妊娠期肝内胆汁淤积症患者疗效研究^*

段楚瑶, 陈庆山, 汪黎明, 贺晓琪

432700 湖北省广水市第一人民医院妇产科（段楚瑶）; 感染病科（陈庆山）; 湖北省妇幼保健院妇产科（汪黎明,贺晓琪）

收稿日期:2018-12-11 出版日期:2019-11-13 发布日期:2019-11-13
通讯作者: 贺晓琪,E-mail:545513575@qq.com
作者简介:段楚瑶,女,35岁,大学本科,主治医师。E-mail:635015469@qq.com
基金资助:
*华中科技大学同济医学院附属协和医院回国人员启动基金资助项目（编号：02.07.15060009）

Clinical efficacy of ursodeoxycholic acid in treatment of patients with intrahepatic cholestasis of pregnancy

Duan Chuyao, Chen Qingshan, Wang Liming, et al.

Department of Obstetrics and Gynecology,First People's Hospital,Guangshui 432700,Hubei Province,China

Received:2018-12-11 Online:2019-11-13 Published:2019-11-13

摘要/Abstract

摘要： 目的探讨应用熊去氧胆酸（UDCA）治疗妊娠期肝内胆汁淤积症（ICP）患者的疗效及其安全性。方法 2015年3月~2018年4月我院收治的ICP患者70例,被随机分为观察组35例和对照组35例,分别给予常规治疗和UDCA治疗4周。采用高效液相色谱串联质谱法检测血清胆汁酸谱,包括石胆酸（LCA）、UDCA、鹅去氧胆酸（CDCA）、胆酸（CA）、甘氨胆酸（GCA）、牛磺石胆酸（TLCA）和总胆酸（TCA）。结果在治疗结束时,观察组和对照组瘙痒评分分别为（1.1±0.3）对（2.3±0.8）,差异显著（P<0.05）;血清ALT水平分别为（25.7±10.0） U/L对（85.1±24.3） U/L,AST分别为（22.6±10.3） U/L对（84.3±11.3） U/L,TBIL分别为（21.6±3.8） μmol/L对（30.5±5.4）μmol/L,差异显著（P<0.05）;血清UDCA分别为（3.2±0.1） μmol/L对（2.5±0.2） μmol/L,CA水平分别为（1.2±0.1） μmol/L对（2.4±0.2） μmol/L,GCA分别为（1.6±0.2） μmol/L对（2.8±0.5） μmol/L,TCA分别为（1.2±0.3） μmol/L对（4.2±0.9） μmol/L,差异显著（P<0.05）;观察组早产、产后出血和新生儿窒息等不良结局发生率显著低于对照组（17.1%对51.4%,P<0.05）。结论应用UDCA治疗ICP患者能显著减轻症状,改善肝功能指标,且无明显的不良后果。

关键词: 妊娠期肝内胆汁淤积症, 熊去氧胆酸, 治疗, 胆汁酸

Abstract: Objective The aim of this study was to investigate the clinical efficacy of ursodeoxycholic acid （UDCA） in treatment of patients with intrahepatic cholestasis of pregnancy （ICP）. Methods 70 patients with ICP were recruited in our hospital between March 2015 and April 2018,and were randomly divided into observation and control group with 35 cases in each. The patients in control group were given conventional treatment,and those in the observation were given UDCA treatment for four weeks. Serum lithocholic acid （LCA）,UDCA,chenodeoxycholic acid （CDCA）,cholic acid （CA）,glycocholic acid （GCA）,taurocholic acid （TLCA） and total cholic acid （TCA） were assayed by high performance liquid chromatography series mass spectrometry. Results At the end of four-week treatment,the pruritis scores in the observation and control group were（1.1±0.3） vs. （2.3±0.8）,respectively （P<0.05）;serum alanine aminotransferase levels were （25.7±10.0） U/L vs. （85.1 ±24.3） U/L （P<0.05）,serum aspartate aminotransferase levels were （22.6±10.3） U/L vs. （84.3±11.3） U/L （P<0.05） and serum bilirubin levels were （21.6±3.8） μmol/L vs. （30.5±5.4） μmol/L （P<0.05）;serum UDCA levels were （3.2±0.1） μmol/L vs. （2.5±0.2） μmol/L,CA were （1.2±0.1） μmol/L vs. （2.4±0.2） μmol/L,GCA were （1.6±0.2） μmol/L vs. （2.8±0.5） μmol/L and TCA were（1.2±0.3） μmol/L vs.（4.2±0.9） μmol/L,all significantly different（P<0.05）;the incidences of premature delivery,postpartum hemorrhage and neonatal asphyxia in the two groups were significantly different（17.1% vs. 51.4%,P<0.05）. Conclusion The application of UDCA in treatment of patients with ICP has efficacious and safe,which might alleviate the clinical symptoms,and improve liver function tests.

Key words: Intrahepatic cholestasis of pregnancy, Ursodeoxycholic acid, Therapy, Bile acid

段楚瑶, 陈庆山, 汪黎明, 贺晓琪. 熊去氧胆酸治疗妊娠期肝内胆汁淤积症患者疗效研究^*[J]. 实用肝脏病杂志, 2019, 22(6): 864-867.

Duan Chuyao, Chen Qingshan, Wang Liming, et al.. Clinical efficacy of ursodeoxycholic acid in treatment of patients with intrahepatic cholestasis of pregnancy[J]. Journal of Practical Hepatology, 2019, 22(6): 864-867.

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熊去氧胆酸治疗妊娠期肝内胆汁淤积症患者疗效研究^*

Clinical efficacy of ursodeoxycholic acid in treatment of patients with intrahepatic cholestasis of pregnancy

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