医药导报
醫藥導報
의약도보
HERALD OF MEDICINE
2015年
8期
1040-1043
,共4页
丁二磺酸腺苷蛋氨酸%熊去氧胆酸%肝内胆汁淤积症,妊娠期
丁二磺痠腺苷蛋氨痠%熊去氧膽痠%肝內膽汁淤積癥,妊娠期
정이광산선감단안산%웅거양담산%간내담즙어적증,임신기
S-adenosy-L-methionine%Ursodeoxycholic acid%Intrahepatic cholestasis,pregnancy
目的：观察丁二磺酸腺苷蛋氨酸( SAMe)联合熊去氧胆酸( UDCA)治疗妊娠期肝内胆汁淤积症( ICP)的临床疗效及安全性。方法将80例ICP患者随机分为治疗组和对照组各40例。对照组静脉滴注SAMe 1.0 g,qd,治疗组联合口服UDCA 250 mg,tid。两组治疗前后分别进行瘙痒评分,检测总胆红素(TB)、血清总胆汁酸(TBA)、甘胆酸( CG)、天门冬酸氨基转移酶( AST)和丙氨酸氨基转移酶( ALT)的血清浓度,记录两组终止妊娠孕周、剖宫产率、早产率、胎儿窘迫发生率、羊水粪染率。结果治疗后两组患者的瘙痒评分均明显降低,治疗组TB、TBA、AST、ALT的含量分别由治疗前的(27.83±9.34),(45.62±18.30)μmol·L-1及(195.98±30.22),(188.69±29.11) U·L-1降低至治疗后的(11.81±4.91),(11.88±2.23)μmol·L-1及(73.59±21.53),(67.94±30.53) U·L-1,对照组TB、TBA、AST、ALT的含量分别由治疗前的(27.49±7.87),(49.12±10.39)μmol·L-1及(211.93±34.97),(210.40±43.39) U·L-1降低至治疗后的(16.08±6.23),(23.88±6.63)μmol·L-1及(87.20±32.52),(81.77±35.16) U·L-1(P<0.05)。治疗组肝功能改善程度、新生儿早产率、胎儿窘迫率、剖宫产率与对照组比较均差异无统计学意义(P>0.05),但治疗组在TB、TBA、CG降低方面优于对照组(P<0.05)。结论单用SAMe在瘙痒症状、肝功能指标改善、妊娠结局方面可以取得与UDCA联用相似的效果,而联合UDCA可以更有效降低甘胆酸和胆汁酸水平。
目的：觀察丁二磺痠腺苷蛋氨痠( SAMe)聯閤熊去氧膽痠( UDCA)治療妊娠期肝內膽汁淤積癥( ICP)的臨床療效及安全性。方法將80例ICP患者隨機分為治療組和對照組各40例。對照組靜脈滴註SAMe 1.0 g,qd,治療組聯閤口服UDCA 250 mg,tid。兩組治療前後分彆進行瘙癢評分,檢測總膽紅素(TB)、血清總膽汁痠(TBA)、甘膽痠( CG)、天門鼕痠氨基轉移酶( AST)和丙氨痠氨基轉移酶( ALT)的血清濃度,記錄兩組終止妊娠孕週、剖宮產率、早產率、胎兒窘迫髮生率、羊水糞染率。結果治療後兩組患者的瘙癢評分均明顯降低,治療組TB、TBA、AST、ALT的含量分彆由治療前的(27.83±9.34),(45.62±18.30)μmol·L-1及(195.98±30.22),(188.69±29.11) U·L-1降低至治療後的(11.81±4.91),(11.88±2.23)μmol·L-1及(73.59±21.53),(67.94±30.53) U·L-1,對照組TB、TBA、AST、ALT的含量分彆由治療前的(27.49±7.87),(49.12±10.39)μmol·L-1及(211.93±34.97),(210.40±43.39) U·L-1降低至治療後的(16.08±6.23),(23.88±6.63)μmol·L-1及(87.20±32.52),(81.77±35.16) U·L-1(P<0.05)。治療組肝功能改善程度、新生兒早產率、胎兒窘迫率、剖宮產率與對照組比較均差異無統計學意義(P>0.05),但治療組在TB、TBA、CG降低方麵優于對照組(P<0.05)。結論單用SAMe在瘙癢癥狀、肝功能指標改善、妊娠結跼方麵可以取得與UDCA聯用相似的效果,而聯閤UDCA可以更有效降低甘膽痠和膽汁痠水平。
목적：관찰정이광산선감단안산( SAMe)연합웅거양담산( UDCA)치료임신기간내담즙어적증( ICP)적림상료효급안전성。방법장80례ICP환자수궤분위치료조화대조조각40례。대조조정맥적주SAMe 1.0 g,qd,치료조연합구복UDCA 250 mg,tid。량조치료전후분별진행소양평분,검측총담홍소(TB)、혈청총담즙산(TBA)、감담산( CG)、천문동산안기전이매( AST)화병안산안기전이매( ALT)적혈청농도,기록량조종지임신잉주、부궁산솔、조산솔、태인군박발생솔、양수분염솔。결과치료후량조환자적소양평분균명현강저,치료조TB、TBA、AST、ALT적함량분별유치료전적(27.83±9.34),(45.62±18.30)μmol·L-1급(195.98±30.22),(188.69±29.11) U·L-1강저지치료후적(11.81±4.91),(11.88±2.23)μmol·L-1급(73.59±21.53),(67.94±30.53) U·L-1,대조조TB、TBA、AST、ALT적함량분별유치료전적(27.49±7.87),(49.12±10.39)μmol·L-1급(211.93±34.97),(210.40±43.39) U·L-1강저지치료후적(16.08±6.23),(23.88±6.63)μmol·L-1급(87.20±32.52),(81.77±35.16) U·L-1(P<0.05)。치료조간공능개선정도、신생인조산솔、태인군박솔、부궁산솔여대조조비교균차이무통계학의의(P>0.05),단치료조재TB、TBA、CG강저방면우우대조조(P<0.05)。결론단용SAMe재소양증상、간공능지표개선、임신결국방면가이취득여UDCA련용상사적효과,이연합UDCA가이경유효강저감담산화담즙산수평。
Objective To observe the clinical effects and the safety of S-adenosy-L-methionine ( SAMe ) associated with ursodeoxycholic acid (UDCA) in treating intrahepatic cholestasis of pregnancy (ICP). Methods Eighty patients with ICP were randomly divided into treatment group ( treated with UDCA orally, 250 mg, TID and simultaneously with intravenous SAMe 1. 0 g, qd) and control group (treated with intravenous SAMe 1. 0 g, qd). Pruritus degree, serum total bilirubin (TB), total bile acid (TBA), glycocholic acid (CG), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were analyzed before and after the treatment, and the pregnancy outcomes, such as the rate of premature, uterine-incision delivery and fetal distress were recorded. Results After treatment, the pruritus degree and the levels of TB, TBA, CG, ALT AST were decreased significantly compared with pretreatment in both groups. TB, TBA, AST and ALT of the treatment group decreased from (27.83±9. 34), (45. 62±18. 30) μmol·L-1, (195. 98±30. 22), (188. 69±29. 11) U·L-1 to (11. 81±4. 91), (11. 88±2. 23) μmol·L-1, (73. 59±21. 53), (67. 94±30. 53) U·L-1, respectively, and TB, TBA, AST, ALT of the control group decreased from (27. 49±7. 87), (49. 12±10. 39) μmol·L-1, (211. 93±34. 9), (210. 40±43. 39) U·L-1 to (16. 08± 6.23), (23.88±6.63) μmol·L-1, (87. 20±32. 52), (81. 77±35. 16) U·L-1, respectively (P<0. 05). Compared with control group, improvements of liver function, the rates of premature delivery, fetal distress and uterine-incision delivery were not significantly different in the treatment group (P>0. 05), but the declines of TB, TBA and CG in treatment group were superior to those of the control group (P<0. 05). Conclusion In terms of improving pruritus, liver function and pregnancy outcome, single SAMe application could obtain similar effects compared with SAMe combined with UDCA, but SAMe combined with UDCA is more effective than the single SAMe application in decreasing the level of TBA and CG.
