摘要
目的探讨地塞米松辅助治疗对妊娠期肝内胆汁淤积症患者免疫功能、肝功能的影响。方法选取2015年5月—2017年5月宁波大学医学院附属医院收治的妊娠期肝内胆汁淤积症患者86例,按照随机数字表法分为对照组(43例)和观察组(43例),对照组患者给予丁二磺酸腺苷蛋氨酸治疗,观察组患者在对照组的基础上给予地塞米松辅助治疗,比较2组患者临床疗效、妊娠结局及新生儿状况、免疫功能及肝功能变化情况。结果观察组患者临床总有效率明显高于对照组(P<0.05);观察组新生儿窒息、胎儿窘迫发生率明显低于对照组(均P<0.05),观察组新生儿Apgar评分明显高于对照组(P<0.05);2组患者治疗后白细胞介素-12(IL-12)、肿瘤坏死因子-α(TNF-α)水平较治疗前明显下降(均P<0.05),且观察组患者IL-12、TNF-α水平明显低于对照组(均P<0.05);2组患者治疗后丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)水平较治疗前明显下降(均P<0.05),且观察组患者ALT、AST水平明显低于对照组(均P<0.05)。结论地塞米松辅助治疗妊娠期肝内胆汁淤积症效果显著,可显著改善患者妊娠结局及新生儿状况,提高患者免疫功能及肝功能,值得在临床上推广应用。
Objective To investigate the effect of dexamethasone adjuvant therapy on immune function and liver function in patients with intrahepatic cholestasis of pregnancy. Methods A total of 86 patients with intrahepatic cholestasis of pregnancy treated in the Affiliated Hospital of Medical School of Ningbo University from May,2015 to May,2017 were randomly divided into control group ( n = 43) and observation group ( n = 43) according to the random number table method. The patients in the control group were treated with adenosine methionine,and the patients in the observation group were treated with dexamethasone on the basis of the control group. The clinical efficacy,pregnancy outcomes and neonatal status,the changes of immune function and liver function were compared between the two groups. Results The total clinical efficiency of the observation group was significantly higher than that of the control group ( P < 0. 05) . The incidence of neonatal asphyxia and fetal distress in the observation group were significantly lower than those in the control group ( P < 0. 05) . The Apgar score of the observation group was significantly higher than that of the control group ( P < 0. 05) . After treatment,the levels of interleukin-12 ( IL-12) and tumor necrosis factor-α( TNF-α) in both of two groups were significantly decreased than those before treament ( P < 0. 05) ,and the levels of IL-12 and TNF-α in the observation group were significantly lower than those in the control group ( P < 0. 05) . After treatment,the levels of alanine aminotransferase ( ALT) and aspartate aminotransferase ( AST) in both of two groups were significantly decreased than those before treament ( P < 0. 05) ,and the levels of ALT and AST in the observation group were significantly lower than those in the control group ( P < 0. 05) . Conclusion Dexamethasone is effective in the treatment of intrahepatic cholestasis of pregnancy. It can significantly improve the outcome of pregnancy and neonatal status,and improve the immune function and liver functi
作者
刘莉萍
宣荣荣
朱虹
周宁
张燕科
张英芝
LIU Li-ping;XUAN Rong-rong;ZHU Hong(Department of Obstetrics,the Affiliated Hospital of Medical School of Ningbo University,Ningbo,Zhejiang 315020,China)
出处
《中华全科医学》
2018年第12期2049-2051,2091,共4页
Chinese Journal of General Practice
基金
2014年浙江省医药卫生科技项目(2014KYB239)
