多烯磷脂酰胆碱对妊娠晚期ICP患者肝功能及妊娠结局的影响的研究.docVIP

多烯磷脂酰胆碱对妊娠晚期ICP患者肝功能及妊娠结局的影响的研究 　　【摘要】 目的：探讨多烯磷脂酰胆碱对妊娠晚期肝内胆汁淤积症（ICP）患者肝功能及妊娠结局的影响。方法：选取2012年1月-2015年1月本院收治的妊娠晚期ICP患者97例作为研究对象，随机分为对照组46例和观察组51例，其中对照组给予熊去氧胆酸联合腺苷蛋氨酸治疗，观察组在对照组治疗的基础上加用多烯磷脂酰胆碱治疗，比较两组患者治疗2周后的肝功能、瘙痒症状改善情况及妊娠结局。结果：两组治疗后瘙痒评分均较治疗前降低，且观察组降低程度高于对照组，观察组瘙痒消失时间及黄疸消失时间均短于对照组，比较差异均有统计学意义（P0.05）；两组治疗后血清TBA、ALT、AST水平均较治疗前明显降低，且观察组降低程度高于对照组，比较差异均有统计学意义（P0.05）；观察组早产、胎儿窘迫、羊水污染发生率合计11.76%，明显低于对照组的28.26%，比较差异有统计学意义（P0.05）。结论：采用熊去氧胆酸联合腺苷蛋氨酸治疗的基础上加用多烯磷脂酰胆碱，可明显改善妊娠晚期ICP患者的肝功能及妊娠结局，且能有效缓解瘙痒症状，值得临床推广。 　　【关键词】 妊娠期肝内胆汁淤积症； 多烯磷脂酰胆碱； 肝功能； 妊娠结局 　　【Abstract】 Objective：To investigate the effect of Phosphatidylcholine on liver function and pregnancy outcome in patients with intrahepatic cholestasis of pregnancy（ICP）.Method：A total of 97 patients with ICP during late pregnancy from January 2012 to January 2015 were selected as the research objects，they were randomly divided into the control group of 46 cases and the observation group of 51 cases，the control group was treated with Ursodeoxycholic Acid combined with Transmetil therapy， the observation group was treated with Phosphatidylcholine on basis of the control group，and the improvement of liver function，the symptoms of pruritus and pregnancy outcome after 2 weeks of treatment in two groups were compared .Result：After treatment，itching scores in two groups were lower than before treatment，and the observation group was lower than that of the control group，the itch disappearance time and the jaundice disappearance time of the observation group were shorter than those of the control group，the differences were statistically significant（P0.05）.The serum levels of TBA，ALT and AST were significantly decreased in two groups after treatment than before treatment，and the observation group was lower than that of the control group，the differences were statistically significant（P0.05）.The incidence of premature labor，fetal distress，amniotic fluid pollution in the observation group was 11.76%，which was significantly lower than 28.26% of the