妊娠期肝内胆汁淤积症孕妇应用思美泰与优思弗联合治疗对患者肝功能及围生儿预后的影响
Effects of Combined Treatment with Transmentil and Ursofalk on Liver Function and Perinatal Prognosis in Pregnant Women with Intrahepatic Cholestasis of Pregnancy
摘要: 目的：分析妊娠期肝内胆汁淤积症(ICP)采取思美泰联合优思弗治疗对患者肝功能及围生儿预后的影响。方法：随机抽签法将144例ICP患者分为思美泰组、优思弗组与联合组，每组48例，分别给予思美泰、优思弗单药治疗及两者联合干预。评价三组疗效、治疗前后肝功能指标、血清白介素-17 (IL-17)、IL-18水平变化、母婴结局及不良反应。结果：联合组治疗总有效率91.67%，均显著高于思美泰组的75.00%及优思弗组的77.08% (P < 0.05)；联合组治疗后瘙痒评分均显著低于思美泰组、优思弗组(P < 0.05)；联合组瘙痒消失时间、黄疸消失时间均显著短于思美泰组、优思弗组(P < 0.05)；联合组治疗后血清总胆汁酸(TBA)、丙氨酸氨基转移酶(ALT)、门冬氨酸转氨酶(AST)、总胆红素(TBIL)、IL-17、IL-18水平均显著低于思美泰组、优思弗组(P < 0.05)；联合组剖宫产率均显著低于思美泰组、优思弗组(P < 0.05)；联合组新生儿Apgar评分均显著高于思美泰组、优思弗组(P < 0.05)；联合组产后出血、早产、胎儿宫内窘迫发生率均低于思美泰组、优思弗组，但差异无显著统计学意义(P > 0.05)。结论：ICP应用思美泰联合优思弗治疗疗效较好，能明显改善患者肝功能，降低血清IL-17、IL-18水平，减少不良围生儿预后。
Abstract: Objective: To analyze the effects of combined treatment with Transmentil and Ursofalk on liver function and perinatal prognosis in pregnant women with intraperitoneal cholestasis of pregnancy (ICP). Methods: 144 patients with ICP were randomly divided into the Transmentil group, the Ursofalk group and the combined group, 48 cases in each group. The three groups were treated with Transmentil, Ursofalk and combination of the two, respectively. The curative effect, liver function indicators before and after treatment, changes in levels of serum interleukin-17 (IL-17) and IL-18, maternal and neonatal outcomes and adverse reactions in all groups were evaluated. Results: The total effective rate of the combined group (91.67%) was significantly higher than that in the Transmentil group (75.00%) or the Ursofalk group (77.08%) (P < 0.05). The pruritus score of the combined group was significantly lower than that of Transmentil group or Ursofalk group (P < 0.05). The disappearance time of pruritus andjaundice in the combined group was significantly shorter than that in the Transmentil group or Ursofalk group (P < 0.05). Levels of serum total bile acid (TBA), alanine aminotransfer(ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), IL-17 and IL-18 in the combined group after treatment were significantly lower than those in the Transmentil group or Ursofalk group (P < 0.05). The cesarean section rate of the combined group was significantly lower than that of the Transmentil group or Ursofalk group (P < 0.05), and the neonatal Apgar score was significantly higher than that in the Transmentil group or Ursofalk group (P < 0.05). The incidence rates of postpartum hemorrhage, premature delivery and fetal intraute-rine distress in the combined group were lower than those in the Transmentil group or Ursofalk group (P > 0.05). Conclusion: The curative effect of combined treatment with Transmentil and Ur-sofalk for ICP is good. It can significantly improve the liver function, reduce serum IL-17 and IL-18 levels, and reduce poor perinatal prognosis. 
文章引用：赵雅萍, 严婷. 妊娠期肝内胆汁淤积症孕妇应用思美泰与优思弗联合治疗对患者肝功能及围生儿预后的影响[J]. 护理学, 2019, 8(6): 404-410. https://doi.org/10.12677/NS.2019.86074

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