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目的:通过研究熊去氧胆酸对妊娠期肝内胆汁淤积症(ICP)的疗效,分析其对围生儿预后的影响。方法:选择241例ICP患者作为研究对象,随机分为3组,A组80例,应用地塞米松治疗,B组80例,在A组的基础上加用熊去氧胆酸治疗,C组81例,应用熊去氧胆酸治疗。观察并分析3组患者的临床疗效及围生儿预后。结果:B组治疗后瘙痒总有效率为98.8%,C组为96.3%,明显高于A组的88.8%,差异有统计学意义(P<0.05);A组患者血清谷丙转氨酶、总胆汁酸和胆红素分别为(65.2±19.6)U/L、(13.5±2.4)μmol/L、(16.7±2.1)μmol/L,B组分别为(40.6±14.2)U/L、(10.1±2.4)μmol/L、(14.2±1.8)μmol/L,C组分别为(43.9±16.1)U/L、(11.2±2.0)μmol/L、(14.9±2.1)μmol/L,A组表达水平明显高于B组和C组,差异有统计学意义(P<0.05);B组和C组患者在羊水粪染、胎儿窘迫、新生儿窒息和早产儿发生率方面均显著低于A组,差异有统计学意义(P<0.05)。结论:熊去氧胆酸对ICP具有较好的疗效,可显著改善围生儿预后。
Objective: To study the effect of ursodeoxycholic acid on intrahepatic cholestasis of pregnancy (ICP) and analyze its effect on the prognosis of perinatal infants. Methods: A total of 241 patients with ICP were selected and randomly divided into three groups. Group A (n = 80) received dexamethasone, group B (n = 80) received UDCA. Group C 81 cases, the application of ursodeoxycholic acid treatment. The clinical efficacy and perinatal outcome of the three groups were observed and analyzed. Results: The total effective rate of itching in group B was 98.8%, in group C 96.3%, which was significantly higher than that in group A 88.8% (P 0.05). The serum levels of alanine aminotransferase, total bile The levels of acid and bilirubin were (65.2 ± 19.6) U / L, (13.5 ± 2.4) μmol / L and (16.7 ± 2.1) μmol / L respectively in group B and 40.6 ± 14.2 U / L in group B (14.4 ± 2.1) μmol / L, (14.4 ± 2.1) μmol / L and (14.2 ± 1.8) μmol / L and Significantly higher than those in group B and group C (P <0.05). Patients in group B and group C were significantly lower than those in group A in meconium-stained amniotic fluid, fetal distress, neonatal asphyxia and preterm infants, The difference was statistically significant (P <0.05). Conclusion: Ursodeoxycholic acid has a good curative effect on ICP and can significantly improve the prognosis of perinatal children.