包头医学院学报
包頭醫學院學報
포두의학원학보
JOURNAL OF BAOTOU MEDICAL COLLEGE
2014年
4期
59-61
,共3页
于坤%陈明%蔡治方%刘瑾
于坤%陳明%蔡治方%劉瑾
우곤%진명%채치방%류근
S-腺苷蛋氨酸%熊去氧胆酸%妊娠肝内胆汁淤积症%Meta分析
S-腺苷蛋氨痠%熊去氧膽痠%妊娠肝內膽汁淤積癥%Meta分析
S-선감단안산%웅거양담산%임신간내담즙어적증%Meta분석
S-adenosyl-L-methionine%UrsodeoXycholic acid%Intrahepatic cholestasis of pregnancy%Meta-analysis
目的：评价S-腺苷蛋氨酸联合熊去氧胆酸治疗妊娠期肝内胆汁淤积症的疗效。方法：计算机检索Co-chrane、MEDLINE、EMbase、CBM、维普、万方、CNKI等，用ReVMan5.0软件进行荟萃分析。结果：经筛选共纳入10个研究，SAMe联合UDCA治疗ICP较单一用药更能降低总胆汁酸（ WMD=-6.07，95％ CI为-11.09~-1.04）、谷丙转氨酶（WMD=-46.40，95％ CI为-69.44~-23.36）及谷草转氨酶（WMD=-22.66，95％ CI为-36.05~-9.28）水平；减轻瘙痒程度（ WMD=-0.75，95％ CI为-1.23~-0.26）；降低剖宫产率（ OR =0.54，95％ CI为0.33~0.90）及早产率（ OR =0.33，95％ CI为0.21~0.52），降低胎儿羊水粪染发生率（ OR =0.36，95％ CI为0.24~0.56），也可降低5分钟Apgar评分≤7分的发生率（ OR =0.21，95％ CI为0.10~0.43）；在分娩孕周（WMD=0.38，95％ CI为-0.35~1.12）及新生儿出生体重（WMD=276.62，95％ CI为-82.46~635.71）方面比较，两组差异无统计学意义（ P >0.05）。结论：SAMe联合UDCA较单一用药更能降低血生化指标，减轻瘙痒程度，改善围产儿结局，但在新生儿出生体重及分娩孕周的比较无优势。
目的：評價S-腺苷蛋氨痠聯閤熊去氧膽痠治療妊娠期肝內膽汁淤積癥的療效。方法：計算機檢索Co-chrane、MEDLINE、EMbase、CBM、維普、萬方、CNKI等，用ReVMan5.0軟件進行薈萃分析。結果：經篩選共納入10箇研究，SAMe聯閤UDCA治療ICP較單一用藥更能降低總膽汁痠（ WMD=-6.07，95％ CI為-11.09~-1.04）、穀丙轉氨酶（WMD=-46.40，95％ CI為-69.44~-23.36）及穀草轉氨酶（WMD=-22.66，95％ CI為-36.05~-9.28）水平；減輕瘙癢程度（ WMD=-0.75，95％ CI為-1.23~-0.26）；降低剖宮產率（ OR =0.54，95％ CI為0.33~0.90）及早產率（ OR =0.33，95％ CI為0.21~0.52），降低胎兒羊水糞染髮生率（ OR =0.36，95％ CI為0.24~0.56），也可降低5分鐘Apgar評分≤7分的髮生率（ OR =0.21，95％ CI為0.10~0.43）；在分娩孕週（WMD=0.38，95％ CI為-0.35~1.12）及新生兒齣生體重（WMD=276.62，95％ CI為-82.46~635.71）方麵比較，兩組差異無統計學意義（ P >0.05）。結論：SAMe聯閤UDCA較單一用藥更能降低血生化指標，減輕瘙癢程度，改善圍產兒結跼，但在新生兒齣生體重及分娩孕週的比較無優勢。
목적：평개S-선감단안산연합웅거양담산치료임신기간내담즙어적증적료효。방법：계산궤검색Co-chrane、MEDLINE、EMbase、CBM、유보、만방、CNKI등，용ReVMan5.0연건진행회췌분석。결과：경사선공납입10개연구，SAMe연합UDCA치료ICP교단일용약경능강저총담즙산（ WMD=-6.07，95％ CI위-11.09~-1.04）、곡병전안매（WMD=-46.40，95％ CI위-69.44~-23.36）급곡초전안매（WMD=-22.66，95％ CI위-36.05~-9.28）수평；감경소양정도（ WMD=-0.75，95％ CI위-1.23~-0.26）；강저부궁산솔（ OR =0.54，95％ CI위0.33~0.90）급조산솔（ OR =0.33，95％ CI위0.21~0.52），강저태인양수분염발생솔（ OR =0.36，95％ CI위0.24~0.56），야가강저5분종Apgar평분≤7분적발생솔（ OR =0.21，95％ CI위0.10~0.43）；재분면잉주（WMD=0.38，95％ CI위-0.35~1.12）급신생인출생체중（WMD=276.62，95％ CI위-82.46~635.71）방면비교，량조차이무통계학의의（ P >0.05）。결론：SAMe연합UDCA교단일용약경능강저혈생화지표，감경소양정도，개선위산인결국，단재신생인출생체중급분면잉주적비교무우세。
ObjectiVe:To eValuate the efficacy of S-adenosyl -L-methionine( SAMe)combined with ursodeoXycholic acid( UDCA)in the treatment of intrahepatic cholestasis of pregnancy( ICP). Methods:The published articles about the treat-ment of ICP with S - adenosyl - L - methionine( SAMe ) combined with UDCA and that with SAMe or UDCA alone were searched in MEDLINE,EMBASE,CBM,Vip,Wanfang,CNKI and Cochrane Library,with the searching results Meta-analyed by software ReVMan5. 0. ResuIts:Meta analysis of total ten articles eligible for criteria showed that the treatment of ICP with SAMe plus UDCA could more effectiVely lower the leVels of total bile acid(WMD= -6. 07,95% CI -11. 09~ -1. 04),ala-nine aminotransferase(WMD= -46. 40,95% CI -69. 44~ -23. 36)and aspartate aminotransferase(WMD= -22. 66,95%CI -36. 05~ -9. 28)than that with SAMe or UDCA alone,with pruritus relieVed,the rate of cesarean section and the rate of preterm birth lowered,the incidence of fetal meconium-stained amniotic fluid reduced,and with incidence of 5 minutes Apgar score≤7 lowered as well. There was no significant difference in gestational age and birth weight between the two therapies. Con-cIusion:Combination therapy of SAMe and UDCA can more effectiVely lower the leVel of blood biochemical indicators than single drug therapy,relieVing pruritus and improVing perinatal outcomes. Combination therapy of SAMe and UDCA shows no adVantage oVer single drug therapy in the regard of birth weight and gestational age.
