【摘要】 目的研究谷胱甘肽联合丁二磺酸腺苷蛋氨酸(ABC)治疗妊娠期肝内胆汁淤积症(ICP)的效果。方法选择2016年2月~2018年2月柳州市人民医院收治的ICP患者80例,采用随机数字表法分为研究组(40例)和对照组(40例)。对照组予以熊去氧胆酸治疗,研究组则采用谷胱甘肽联合丁二磺酸腺苷蛋氨酸(ABC)治疗。分析两组疗效,治疗前后肝功能指标[谷草转氨酶(AST)、胆汁酸(TBA)、谷丙转氨酶(ALT)]水平以及血清白细胞介素-18(IL-18)、肿瘤坏死因子α(TNF-α)水平变化情况,记录两组不良妊娠结局发生情况。结果研究组治疗总有效率高于对照组(P <0.05)。治疗后两组AST、TBA、ALT水平均低于治疗前(P <0.05),且研究组低于对照组(P <0.05)。治疗后两组血清IL-18、TNF-α水平低于治疗前(P <0.05),且研究组上述各项指标水平低于对照组(P <0.05)。研究组羊水污染、胎儿窘迫发生率低于对照组(P <0.05)。结论谷胱甘肽联合ABC治疗ICP的效果显著,有利于降低肝功能损害,同时可减少不良妊娠结局的发生,值得临床推广应用。更多还原

【Abstract】 Objective To study the effect of glutathione combined with adenosylmethionine butadiesulfonic acid(ABC in the treatment of intrahepatic cholestasis of pregnancy(ICP). Methods From February 2016 to February 2018, in Liuzhou General Hospital, 80 patients with ICP were selected, they were divided into study group(40 cases) and control group(40 cases) according to the random number table method. The control group was treated with ursodeoxycholic acid, the study group was treated with glutathione combined with ABC. The clinical efficacy and the change of liver function index [aspartate aminotransferase(AST), bile acid(TBA), alanine transaminase(ALT)] and serum interleukin-18(IL-18), tumor necrosis factor-α(TNF-α) were analyzed, and adverse pregnancy outcome of the two groups before and after treatment was recorded. Results The total effective rate of the study group was higher than the control group(P < 0.05). The levels of AST, TBA and ALT in the two groups were lower than before the treatment(P < 0.05), and the study group was lower than the control group(P < 0.05). The serum levels of IL-18 and TNF-α in the two groups were lower than those before treatment(P < 0.05), and the study group was lower than the control group(P < 0.05). The incidence of amniotic fluid contamination and fetal distress in the study group were lower than those in the control group(P < 0.05). Conclusion Glutathione combined with ABC in the treatment of ICP has a significant effect,it is helpful to reducing liver function damage, and reducing the incidence of adverse pregnancy outcome. It is worthy of clinical application.更多还原