【摘要】 目的探讨复方丹参注射液联合多烯磷脂酰胆碱对妊娠期肝内胆汁淤积症(ICP)患者血清血管内皮生长因子(VEGF)、γ-干扰素(IFN-γ)水平及新生儿结局的影响,为及时纠正免疫紊乱、改善新生儿结局提供理论依据。方法选择70例ICP患者随机分为观察组和对照组各35例,对照组患者给予复方丹参注射液治疗,观察组患者给予复方丹参注射液+多烯磷脂酰胆碱治疗,均持续治疗10 d。比较两组患者瘙痒消失时间、黄疸消失时间及治疗前、后瘙痒评分,检测对比两组患者治疗前、后肝功能指标[总胆汁酸(TBA)、谷草转氨酶(AST)、谷丙转氨酶(ALT)]及血清VEGF、IFN-γ水平,统计对比两组新生儿结局。结果治疗前两组患者瘙痒评分差异无统计学意义(P>0.05);治疗后观察组患者瘙痒评分低于对照组,瘙痒消失时间、黄疸消失时间短于对照组,差异均有统计学意义(P<0.05)。治疗前两组患者TBA、AST、ALT及血清VEGF、IFN-γ水平差异均无统计学意义(P>0.05);治疗后观察组患者TBA、AST、ALT、IFN-γ水平低于对照组,血清VEGF水平高于对照组,差异均有统计学意义(P<0.05)。观察组新生儿缺血缺氧性脑病、黄疸、窒息及低体质量新生儿发生率均低于对照组,差异均有统计学意义(P<0.05)。观察组患者不良反应发生率17.14%高于对照组的11.43%,但差异无统计学意义(P>0.05)。结论采用复方丹参注射液联合多烯磷脂酰胆碱治疗ICP能有效缓解瘙痒、黄疸症状,改善肝功能,提高血清VEGF水平,纠正免疫紊乱,改善新生儿结局。更多还原

【Abstract】 Objective To explore the effect of compound Danshen injection combined with polyene phosphatidylcholine on serum vascular endothelial growth factor( VEGF),interferon-γ( IFN-γ) levels and neonatal outcomes in patients with intrahepatic cholestasis of pregnancy( ICP),provide a theoretical basis for timely correcting immune disorder and improving neonatal outcome. Methods Seventy ICP patients were selected and randomly divided into control group and observation group,35 patients in each group. The patients in control group were treated with compound Danshen injection,and the patients in observation group were treated with compound Danshen injection and polyene phosphatidylcholine. The patients in the two groups were treated for 10 days. The disappearance time of itching and jaundice,the itching scores before and after treatment in the two groups were compared. The levels of liver function indexes [total bile acid( TBA),aspartate aminotransferase( AST),alanine aminotransferase( ALT) ] and serum VEGF and IFN-γ before and after treatment in the two groups were detected and compared,the neonatal outcomes in the two groups were analyzed. Results Before treatment,there was no statistically significant difference in the itching scores between the two groups( P> 0. 05); after treatment,the itching score in observation group was statistically significantly lower than that in control group( P<0. 05),the disappearance time of itching and jaundice were statistically significantly shorter than those in control group( P<0. 05). There was no statistically significant difference in the levels of TBA,AST,ALT,and serum VEGF and IFN-γ between the two groups before treatment( P > 0. 05); after treatment,the levels of TBA,AST,ALT,and IFN-γ in observation group were statistically significantly lower than those in control group,while serum VEGF level was statistically significantly higher than that in control group( P<0. 05). The incidence rates of neonatal hypoxic-hypoxic encephalopathy,jaundice,asphyxia,and neonatal low birth weight in observation group were statistically significantly lower than those in control group( P<0. 05). There was no significant difference in the incidence rate of adverse reactions between observation group( 17. 14%) and control group( 11. 43)( P >0. 05). Conclusion Compound Danshen injection combined with polyene phosphatidylcholine in treatment of ICP can effectively relieve itching and jaundice,improve liver function and serum VEGF level,correct immune disorder,and improve neonatal outcome.更多还原