摘要
目的:观察柴胡桂枝汤对妊娠期肝内胆汁淤积症(ICP)的治疗疗效。方法:将60例ICP患者随机分为对照组及治疗组,每组30例。对照组给予西药常规方案治疗,治疗组在西医标准治疗方案基础上加用柴胡桂枝汤治疗,疗程为7天。评价两组治疗后瘙痒程度、血清总胆红素(TBil)、血清总胆汁酸(TBA)、丙氨酸氨基转移酶(ALT)及天门冬氨酸氨基转移酶(AST)水平的变化及其对妊娠结局的影响。结果:治疗组在瘙痒程度、TBil、TBA、ALT及AST降低程度均较对照组降低(P<0.05);治疗组在胎儿窘迫,胎儿生长受限,早产发生等数据上均低于对照组(P<0.05)。结论:柴胡桂枝汤对ICP的治疗疗效可靠。
Objective:This study aimed to investigate the relationship between serum prealbumin to total bilirubin(PA/TB)ratio,albumin-bilirubin(ALBI)score,model for end-stage liver disease(MELD)and the clinical outcome of Hepatitis B virus related acute-on-chronic liver failure(HBV-ACLF).Methods:Totally 132 patients hospitalized who developed HBV-ACLF were enrolled and divided into survival group(82 cases)and death/transplant group(50 cases),followed up for 3 months.Subjects were tested for serum PA,albumin(ALB),TB,creatinine(CRE),and INR at baseline.Compare PA/TB,ALBI scores,and MELD scores between these two groups.Evaluate the value of those indexes on clinical prognosis of HBV-ACLF by method of area under the receiver operating characteristic(AUROC)curves.Results:The serum PA/TB was 0.09±0.04 in death/transplant group,significantly lower than that in survival group(0.16±0.08,P<0.05).The score of ALBI was-0.64±0.22 in death/transplant group which was significantly higher than that in survival group(-0.83±0.27,P<0.05).The MELD score was 28.15±4.14 and significantly higher than that in survival group(23.07±3.6,P<0.05).The AUC of PA/TB,ALBI score,MELD score,PA/TB combined with MELD score for HBV-ACLF prognosis were0.747(95%CI:0.661~0.834),0.716(95%CI:0.624~0.808),0.845(95%CI:0.776~0.914),0.861(95%CI:0.795~0.927),respectively.According to Pearson correlation analysis,the correlation index of PA/TB,ALBI score,MELD score in survival/transplant group were 0.421,-0.352,-0.549 respectively.Conclusion:Serum PA/TB ratio,ALBI score,MELD score can predict the prognosis in patients with HBV-ACLF.The higher PA/TB ratio and the lower the ALBI score,MELD score,related to better prognosis.The combination of PA/TB and MELD score on HBV-ACLF prognosis prediction was significantly better than that of MELD score or ALBI score.But more research is needed to confirm that.
作者
陈德新
李姝汶
何荣霞
CHEN Dexin;LI Shuwen;HE Rongxia(Lanzhou University second hospital)
出处
《中西医结合肝病杂志》
CAS
2020年第5期414-416,共3页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
基金
兰州大学第二医院中医药科研项目(No.YJzy2013-29)。
关键词
妊娠期肝内胆汁淤积症
柴胡桂枝汤
临床疗效
serum prealbumin and total bilirubin ratio
ALBI score
MELD score
chronic acute liver failure
prognosis
