熊去氧胆酸、腺苷蛋氨酸联合多烯磷脂酰胆碱治疗ICP的疗效及对母婴结局的影响

肝脏 ›› 2025, Vol. 30 ›› Issue (9): 1276-1279.

熊去氧胆酸、腺苷蛋氨酸联合多烯磷脂酰胆碱治疗ICP的疗效及对母婴结局的影响

韩亚琴, 金彦琪, 黄丽丽, 成翔燕

226001 南通南通市第六人民医院妇产科(韩亚琴,黄丽丽);226001 南通南通市妇幼保健院妇产科(金彦琪);226001 南通南通市第三人民医院妇产科(成翔燕)

收稿日期:2025-03-30 出版日期:2025-09-30 发布日期:2025-11-05
通讯作者: 成翔燕
基金资助:
南通市科技计划项目(MSZ2022006)

Efficacy of ursodeoxycholic acid and S-adenosylmethionine combined with polyene phosphorylcholine in treating intrahepatic cholestasis of pregnancy and its impact on maternal and neonatal outcomes

HAN Ya-qin¹, JIN Yan-qi², HUANG Li-li¹, CHENG Xiang-yan³

1. Department of Obstetrics and Gynecology,Nantong Sixth People's Hospital, Nantong 226001,China;
2. Department of Obstetrics and Gynecology,Nantong Maternal and Child Health Hospital, Nantong 226001, China;
3. Department of Obstetrics and Gynecology,Nantong Third People's Hospital, Nantong 226001,China

Received:2025-03-30 Online:2025-09-30 Published:2025-11-05
Contact: CHENG Xiang-yan

摘要/Abstract

摘要： 目的观察熊去氧胆酸及腺苷蛋氨酸联合多烯磷脂酰胆碱治疗ICP患者的临床疗效,评估其对肝功能、血清胆汁酸、母婴结局的影响。方法选取2019年5月至2024年5月南通市第六人民医院、南通市第三人民医院及南通市妇幼保健院三家医院的产科门诊规范产检并住院分娩的80例ICP患者作为研究对象,根据治疗方法分为观察组、对照组,比较两组肝功能、血清胆汁酸、母婴结局的差异。结果与治疗前比,观察组、对照组治疗后瘙痒评分、ALT、TAB及TBil等水平显著降低(P<0.05),且观察组降低程度更为显著(P<0.05),另外观察组黄疸消失时间也显著短于对照组[(6.0±1.7)d比(8.1±2.3)d,P<0.05]。治疗后,观察组胆酸、甘氨胆酸及牛磺胆酸显著低于对照组(P<0.05),而脱氧胆酸显著高于对照组(P<0.05);观察组患者妊娠终止时间、新生儿体质量显著高于对照组(P<0.05),而产后出血、剖宫产、羊水污染及早产例数显著低于对照组(P<0.05)。结论熊去氧胆酸及腺苷蛋氨酸联合多烯磷脂酰胆碱治疗ICP,在改善肝功能、缓解临床症状、优化胆汁酸谱及提高母婴结局方面具有显著疗效,值得临床进一步推广与应用。

关键词: 肝内胆汁淤积症, 腺苷蛋氨酸, 多烯磷脂酰胆碱

Abstract: Objective To observe the clinical efficacy of ursodeoxycholic acid and S-adenosylmethionine combined with polyene phosphorylcholine in the treatment of ICP patients, and to evaluate their effects on liver function, serum bile acid and maternal and infant outcomes. Methods A total of 80 ICP patients who received standardized prenatal care in the obstetrics outpatient clinics and delivered in the hospitals were selected from Nantong Sixth People's Hospital, Nantong Third People's Hospital, and Nantong Maternal and Child Health Hospital between May 2019 and May 2024. These patients were divided into a control group and a experimental group based on the administration of polyene phosphorylcholine. The differences in liver function, serum bile acids, and maternal-neonatal outcomes between the two groups were compared. Results Both groups exhibited marked reductions in pruritus severity scores, ALT levels, total bile acids (TBA), and total bilirubin (TBil) post-treatment compared to baseline values (all P<0.05), with the experimental group achieving significantly greater decreases in these parameters (P<0.05). Notably, the experimental group demonstrated a shorter duration of jaundice resolution compared to control group [(6.0±1.7) days vs. (8.1±2.3 days; P<0.05]. After treatment, compared with the control group, levels of cholic acid, glycocholic acid, and taurocholic acid in the experimental group were significantly lower (all P<0.05), while deoxycholic acid was significantly higher (P<0.05). Furthermore, the experimental group displayed significantly prolonged gestational age at delivery and higher neonatal birth weights (P<0.05), accompanied by reduced incidences of postpartum hemorrhage, cesarean section, meconium-stained amniotic fluid, and preterm birth when compared to the control group (all P<0.05). Conclusion Ursodeoxycholic acid and S-adenosylmethionine combined with polyene phosphorylcholine demonstrates significant efficacy in improving liver function, alleviating clinical symptoms, optimizing bile acid profiles, and enhancing maternal and neonatal outcomes in ICP patients, warranting further clinical promotion and application.

Key words: Intrahepatic cholestasis of pregnancy, S-Adenosylmethionine, Polyene phosphorylcholine

韩亚琴, 金彦琪, 黄丽丽, 成翔燕. 熊去氧胆酸、腺苷蛋氨酸联合多烯磷脂酰胆碱治疗ICP的疗效及对母婴结局的影响[J]. 肝脏, 2025, 30(9): 1276-1279.

HAN Ya-qin, JIN Yan-qi, HUANG Li-li, CHENG Xiang-yan. Efficacy of ursodeoxycholic acid and S-adenosylmethionine combined with polyene phosphorylcholine in treating intrahepatic cholestasis of pregnancy and its impact on maternal and neonatal outcomes[J]. Chinese Hepatolgy, 2025, 30(9): 1276-1279.

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