Clinical Study of S-Adenosyl-L-Methionine Combined with Ursodeoxycholic Acid in Treatment of 40 Cases with Intrahepatic Cholestasis of Pregnancy
10.3870/yydb.2015.08.013
- VernacularTitle:丁二磺酸腺苷蛋氨酸联合熊去氧胆酸治疗妊娠期肝内胆汁淤积症40例
- Author:
Yu ZHU
;
Xiaoping HUANG
;
Han XIE
- Publication Type:Journal Article
- Keywords:
S-adenosy-L-methionine;
Ursodeoxycholic acid;
Intrahepatic cholestasis,pregnancy
- From:
Herald of Medicine
2015;(8):1040-1043
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the clinical effects and the safety of S-adenosy-L-methionine ( SAMe ) associated with ursodeoxycholic acid (UDCA) in treating intrahepatic cholestasis of pregnancy (ICP). Methods Eighty patients with ICP were randomly divided into treatment group ( treated with UDCA orally, 250 mg, TID and simultaneously with intravenous SAMe 1. 0 g, qd) and control group (treated with intravenous SAMe 1. 0 g, qd). Pruritus degree, serum total bilirubin (TB), total bile acid (TBA), glycocholic acid (CG), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were analyzed before and after the treatment, and the pregnancy outcomes, such as the rate of premature, uterine-incision delivery and fetal distress were recorded. Results After treatment, the pruritus degree and the levels of TB, TBA, CG, ALT AST were decreased significantly compared with pretreatment in both groups. TB, TBA, AST and ALT of the treatment group decreased from (27.83±9. 34), (45. 62±18. 30) μmol·L-1, (195. 98±30. 22), (188. 69±29. 11) U·L-1 to (11. 81±4. 91), (11. 88±2. 23) μmol·L-1, (73. 59±21. 53), (67. 94±30. 53) U·L-1, respectively, and TB, TBA, AST, ALT of the control group decreased from (27. 49±7. 87), (49. 12±10. 39) μmol·L-1, (211. 93±34. 9), (210. 40±43. 39) U·L-1 to (16. 08± 6.23), (23.88±6.63) μmol·L-1, (87. 20±32. 52), (81. 77±35. 16) U·L-1, respectively (P<0. 05). Compared with control group, improvements of liver function, the rates of premature delivery, fetal distress and uterine-incision delivery were not significantly different in the treatment group (P>0. 05), but the declines of TB, TBA and CG in treatment group were superior to those of the control group (P<0. 05). Conclusion In terms of improving pruritus, liver function and pregnancy outcome, single SAMe application could obtain similar effects compared with SAMe combined with UDCA, but SAMe combined with UDCA is more effective than the single SAMe application in decreasing the level of TBA and CG.
