曾霞

【摘要】 目的：探究腺苷蛋氨酸联合多烯磷脂酰胆碱对妊娠期肝内胆汁淤积症（Intrahepatic Cholestasis of Pregnancy， ICP）患者肝功能及妊娠结局的影响。方法：选取本院收治的ICP患者160例，随机分为观察组和对照组，每组各80例。对照组患者给予腺苷蛋氨酸静脉滴注+熊去氧胆酸片口服治疗，观察组在对照组治疗的基础上联合多烯磷脂酰胆碱滴注治疗。比较两组患者肝功能以及妊娠结局之间的差异。结果：两组患者血清ALT、AST以及TBA水平均明显低于治疗前，且观察组明显低于对照组（P<0.05）。观察组孕妇分娩孕周明显高于对照组，剖宫产产后出血发生率明显低于对照组（P<0.05）。结论：腺苷蛋氨酸联合多烯磷脂酰胆碱治疗ICP的临床疗效显著，能改善患者肝功能，且妊娠结局、新生儿结局更好。

【关键词】 妊娠期肝内胆汁淤积症;肝功能;多烯磷脂酰胆碱;腺苷蛋氨酸

Effects of Adenosine Methionine Combined with Polyene Phosphatidylcholine on Liver Function and Pregnancy Outcome in Patients with Intrahepatic Cholestasis of Pregnancy

Zeng Xia

Weiyuan County People's Hospital， Neijiang， Sichuan， 642450

[Abstract] Objective：To investigate the effect of adenosine methionine combined with polyene phosphatidylcholine on liver function and pregnancy outcome in patients with intrahepatic cholestasis of pregnancy （Intrahepatic Cholestasis of Pregnancy， ICP）. Methods： 160 patients with ICP were randomly divided into observation group （80 cases） and control group （80 cases）. The patients in the control group were treated by intravenous infusion of ursodeoxycholic acid tablets by intravenous drip of adenosine methionine， and the patients in the observation group were treated with polyene phosphatidylcholine drip on the basis of the treatment in the control group. After 10 days of treatment， the liver function of the two groups was compared. And the differences in pregnancy outcomes. Results： The levels of serum ALT，AST and TBA in the two groups were significantly lower than those before treatment， and the level in the observation group was significantly lower than that in the control group （P<0 05）. The pregnant women in the observation group were significantly higher than those in the control group in gestational weeks and the incidence of postpartum hemorrhage after cesarean section was significantly lower than that in the control group （P<0.05）. Conclusion： Adenosine methionine combined with polyene phosphatidylcholine is effective in the treatment of ICP， and can improve the liver function of the patients， and the pregnancy outcome and neonatal outcome are better.

[Key words]Intrahepatic cholestasis of pregnancy; Liver function; Polyene phosphatidylcholine; Adenosine methionine

ICP是一种以皮肤瘙痒、胆汁酸升高、肝脏酶水平异常为临床特征的妊娠期疾病，好发于妊娠中晚期。ICP患者的预后良好，临床特征在分娩后多可恢复正常，但妊娠中晚期发病ICP可增加不良妊娠结局和新生儿结局的发生风险，因此在ICP发病早期及时给予针对性治疗具有重要意义[1]。熊去氧胆酸、腺苷蛋氨酸是临床治疗ICP较为成熟的药物，其安全性得到临床的认可，但其临床疗效仍不够理想。近年来不断有研究表明，多烯磷脂酰胆碱可显著改善肝功能和稳定胆汁酸水平。但关于传统药物熊去氧胆酸、腺苷蛋氨酸与多烯磷脂酰胆碱在ICP临床治疗中联合应用的报道较少，且尚需临床数据加以验证[2]。本研究笔者通过设立对照实验，对比了熊去氧胆酸、腺苷蛋氨酸与多烯磷脂酰膽碱联合治疗方案与传统治疗方案对ICP患者的临床疗效，旨在为ICP的临床治疗提供参考，现将研究情况汇报如下。……