摘要
目的:分析熊去氧胆酸治疗对妊娠期肝内胆汁淤积症(ICP)患者妊娠结局的影响及不良妊娠结局的影响因素。方法:选取瑞金市人民医院妇产科2019年4月—2022年4月收治的ICP患者66例为研究对象,通过病历号数字表抽签法将患者分为观察组(n=33)和对照组(n=33)。对照组采用常规方案治疗,观察组在对照组的基础上联合熊去氧胆酸治疗。对比两组治疗前后肝功能[谷丙转氨酶(ALT)、总胆汁酸(TBA)和谷草转氨酶(AST)];对比两组临床症状改善情况、临床治疗效果和不良妊娠结局等相关指标;对比不良妊娠结局和正常妊娠结局患者的临床资料,并通过logistic回归分析影响ICP患者妊娠结局的危险因素。结果:两组治疗后的ALT、TBA、AST、瘙痒评分均明显降低,且相较于对照组,观察组ALT、TBA、AST和瘙痒评分均明显更低(P<0.05);相较于对照组,观察组黄疸消退时间明显更早(P<0.05);对照组临床总有效率为78.79%(26/33),低于观察组的96.97%(32/33)(P<0.05);相较于对照组,观察组孕周明显更长,出生后5 min新生儿Apgar评分、产后出血量、剖宫产率、围生儿死亡率、胎儿窘迫率和羊水粪染率均明显更低(P<0.05)。不良妊娠结局患者ICP发病时间≤34周、总胆汁酸>40μmol/L、丁二磺酸腺苷蛋氨酸治疗占比均高于正常妊娠结局患者(P<0.05);ICP发病时间≤34周、入院时总胆汁酸水平>40μmol/L、丁二磺酸腺苷蛋氨酸治疗均是ICP患者不良妊娠结局的危险因素(P<0.05)。结论:熊去氧胆酸治疗ICP的临床效果较好,能够明显改善肝功能和临床症状,同时降低不良妊娠结局的发生;ICP发病时间、总胆汁酸水平、丁二磺酸腺苷蛋氨酸治疗是ICP患者妊娠结局的危险因素。
Objective:To analyze the impact of Ursodeoxycholic Acid treatment on the pregnancy outcome of intrahepatic cholestasis of pregnancy(ICP)and influencing factors of adverse pregnancy outcomes.Method:A total of 66 ICP patients admitted to Ruijin People's Hospital from April 2019 to April 2022 were selected as the research subjects.The patients were divided into the observation group(n=33)and the control group(n=33)using the medical record number table drawing method.The control group was treated with conventional regimens,while the observation group was treated with Ursodeoxycholic Acid on the basis of the control group.The liver function[alanine transaminase(ALT),total bile acid(TBA),and aspartate transaminase(AST)]of the two groups were compared before and after treatment;the improvement of clinical symptoms,clinical treatment effectiveness,and adverse pregnancy outcomes between the two groups of patients were compared;clinical data of patients with adverse pregnancy outcomes and normal pregnancy outcomes were compared,and the risk factors affecting pregnancy outcomes in ICP patients through logistic regression were analyzed.Result:After treatment,the ALT,TBA,AST,and itching scores of both groups of patients were significantly reduced,and compared with the control group,the ALT,TBA,AST and pruritus scores in the observation group were significantly lower(P<0.05);compared with the control group,the jaundice subsided time in the observation group was significantly earlier(P<0.05);the total effective rate of the control group was 78.79%(26/33),which was lower than 96.97%(32/33)of the observation group(P<0.05);compared with the control group,the gestational age of the observation group was significantly longer,and the neonatal Apgar score at 5 min after birth,postpartum hemorrhage,cesarean section rate,perinatal mortality rate,fetal distress rate and meconium-stained amniotic fluid rate were significantly lower(P<0.05).Patients with adverse pregnancy outcomes with ICP onset time≤34 weeks and total bile acid>40μmol/
作者
熊烨
熊光华
钟汉
XIONG Ye;XIONGGuanghua;ZHONG Han(Department of Obstetrics and Gynecology,Ruijin People's Hospital,Ruijin 342500,China;不详)
出处
《中国医学创新》
CAS
2024年第11期153-157,共5页
Medical Innovation of China
基金
赣州市指导性科技计划项目(20222ZDX8895)。
关键词
熊去氧胆酸
妊娠期
肝内胆汁淤积症
影响因素
Ursodeoxycholic Acid
Pregnancy period
Intrahepatic cholestasis
Influence factor
