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1、妊娠期肝内胆汁瘀积症的治疗与围产儿预后关系的探讨【关键词】妊娠期肝内胆汁瘀积症［摘要］目的：评估熊去氧胆酸（UDCA）、地塞米松（DX）治疗妊娠期肝内胆汁瘀积症（ICP）的疗效及围产儿预后情况。方法:126例患者随机分为UDCA组（A组、DX组（B组）和对照组（C组），各42例，A、B、C3组血清胆汁酸TBA（10〜50nmol/L）分别为A1组30例、B1组27例、C1组29例;TBA>50umol/L分别为A2组12例、B2组15例、C2组13例。A组给予UDCAlOOmg,3次/d,14d为1个疗程;B组给予DX3mg,3
2、次/d,10d后逐渐减量而停药;C组给予口服维生素CO.2g,连续服用14do结果：A、B组患者治疗后皮肤瘙痒症状明显减轻（P<0.05）,C组瘙痒症状无变化;A、B2组治疗后血TBA明显下降（P〈0・05）;A2组下降程度大于B2组（PC0.05）,C组稍上升（P〉0・05）;3组内早产、胎儿窘迫、新生儿窒息的发生率与TBA值呈正相关，A、B组的发生率明显低于C组，差异有显著性（P〈0・05）,A、B组内TBA值低的组（A1、B1组）早产、胎儿窘迫、新生儿窒息发生率差异无显著性（P>0.05）,TAB值高的组（A2、B2组）早
3、产、胎儿窘迫、新生儿窒息的发生率差异有显著性（P〈0.05）。结论：UDCA、DX均能有效治疗ICP,减少早产、胎儿窘迫、新生儿窒息的发生率，对于TBA值高的患者，UDCA疗效优于DX,仅口服维生素C不能有效治疗ICPo［关键词］妊娠期肝内胆汁瘀积症;血清胆汁酸;熊去氧胆酸;胎儿窘迫;新生儿窒息RelationshipbetweentreatmentofintrahepaticcholestasisduringpregnancyandprognosisofprenataiinfantWANGZhong-ying,LINYin-x
4、iang(SuixiPeople，sHospital,Suixi524300,China)Abstract:Toevaluatetheeffectofursodeoxycholicacid(UDCA)anddexamethasone(DX)onintrahepaticcholestasisduringpregnancyandprognosisoftheperinatalinfant・Methods:126patientswererandomlydividedintotheUDCAgroup(GroupA),DXgroup(Gro
5、upB)andthecontrolgroup(GroupC),with42patientsineachgroup・Andpatientsinthe3groupswerefurtherdividedintotwosub-groupsinaccordancewiththelevelofserumbileacid・Therewere30casesinA1,27casesinB1,and29casesinC1,with10umol/L6、roupB2,andl3casesinGroupC2respec-tively,withTBA>50umol/L.PatientsinGroupAweretreatedwithUDCA,atadoseoflOOmg,3timesadayforasuccessionof14days・PatientsinGroupBweretreatedwithDX,atadoseof3mg,also3timesadayforasuccessionoflOdays,afterwhichmedicationwasreducedandfinallyte
7、rminated・PatientsinGroupCweregivenvitaminC,0.3g,3timesadayforasuccessionof14days・ResuIts:ForpatientsinGroupAandGroupB,thesymptomofprurituswasreleasedsignificantlyaftertreatment(P<0.05),whilesymptomremainedunchangedforpatientsinGroupC・ThelevelofserumbileacidinGroupAan
8、dBreducedsignificantly(P<0.05),withthereductioninTBAbeinggreaterinA2thanthatinB2(P<0.05),whilethatofGroupCroseslightly(P<0.05)・Inci
