摘要目的 探讨丁二磺酸腺苷蛋氨酸联合还原型谷胱甘肽治疗妊娠期肝内胆汁淤积症的效果.方法 选取2015年5月至2018年5月三门峡市中心医院收治的60例妊娠期肝内胆汁淤积症患者,按照随机数字表法将其分为研究组和对照组,每组30例.对照组在常规治疗基础上加用丁二磺酸腺苷蛋氨酸,研究组在常规治疗基础上加用还原型谷胱甘肽、丁二磺酸腺苷蛋氨酸.比较两组实验室指标[胆汁酸(TBA)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)]变化及妊娠结局.结果 治疗前,两组TBA、ALT、AST检测值比较差异未见统计学意义(P>0.05);治疗后,两组TBA、ALT、AST检测值均低于治疗前,且研究组下降幅度优于对照组(P<0.05).研究组自然分娩率为73.33％(22/30),对照组为46.67％(14/30),P<0.05;研究组早产、胎儿宫内窘迫率分别为3.33％(1/30)、3.33％(1/30),均低于对照组的23.33％(7/30)、23.33％(7/30),P<0.05.结论 联合应用还原型谷胱甘肽、丁二磺酸腺苷蛋氨酸治疗妊娠期肝内胆汁淤积症,能够提高患者实验室相关指标的改善幅度,有效保障其妊娠结局.

abstractsObjective To evaluate the clinical value of succinic acid adenosine methionine and reduced glutathione in the treatment of intrahepatic cholestasis of pregnancy.Methods Sixty patients with intrahepatic cholestasis of pregnancy admitted in Sanmenxia Central Hospital from May 2015 to May 2018 were selected.According to the random number table method,they were divided into study group and control group,with 30 cases in each group.Patients in the control group were treated with succinic acid adenosine methionine on the basis of routine treatment.And patients in the study group were treated with reduced glutathione and succinic acid adenosine methionine on the basis of routine treatment.The changes of laboratory parameters,such as total bile acid (TBA),alanine aminotransferase (ALT), aspartate aminotransferase (AST),and pregnancy outcomes were compared between the two groups. Results Before treatment,there was no significant difference in TBA,ALT or AST between the two groups (P>0. 05 );after treatment,the TBA,ALT and AST values of the two groups were lower than those before treatment,and the decline of the study group was more significant than that of the control group (P<0. 05 ).The natural delivery rate was 73. 33％(22/30 )in the study group and 46. 67％(14/30)in the control group (P<0. 05).The rates of premature delivery and fetal distress in the study group were 3. 33％(1/30)and 3. 33％(1/30),which were lower than the 23. 33％(7/30)and 23.33％ (7/30)in the control group (P <0.05).Conclusions Combined application of reduced glutathione and succinic acid adenosine methionine in the treatment of intrahepatic cholestasis of pregnancy can promote the improvement of laboratory related indexes and effectively ensure the pregnancy outcomes of patients with intrahepatic cholestasis of pregnancy.