Ursodeoxycholic acid for the treatment of intrahepatic cholestasis of pregnancy.
Ursodeoxycholic acid for the treatment of intrahepatic cholestasis of pregnancy.
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DOI：
10.1080/714052719
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发表时间：
2001-04-01
期刊：
影响因子：
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通讯作者：
Whetham, J C
中科院分区：
文献类型：
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作者：
Laifer, S A;Stiller, R J;Whetham, J C
目的：报告我们使用熊去氧胆酸治疗妊娠肝内胆汁淤积症的经验。方法：对1997年1月至1999年8月在布里奇波特医院诊断的所有妊娠肝内胆汁淤积症病例进行分析。资料摘要包括人口统计、医疗和产科史、症状、实验室数据、治疗和妊娠结局。统计分析主要是描述性的；用t检验分析连续变量。结果：共发现妊娠肝内胆汁淤积症20例（占活产婴儿的0.32%）。所有患者均出现瘙痒。出现症状时的平均胎龄为31.1周（范围13-38.4周，中位数32.4周）。18例患者胆汁酸均升高。分娩时平均胎龄36.4周（32.3 ~ 39.9周）。8例患者采用熊去氧胆酸（600 ~ 1200mg）治疗。所有8例患者在开始熊去氧胆酸治疗后，瘙痒症状均有主观改善。在大多数患者中，熊去氧胆酸与胆汁酸降低相关（p = 0.16），与血清转氨酶显著降低相关（p = 0.03）。结论：熊去氧胆酸是缓解妊娠期肝内胆汁淤积引起的瘙痒和改善肝功能障碍的有效药物。
OBJECTIVE: To report our experience in managing intrahepatic cholestasis of pregnancy with ursodeoxycholic acid.METHODS: All cases of intrahepatic cholestasis of pregnancy that were diagnosed at Bridgeport Hospital from January 1997 to August 1999 were identified. Information was abstracted on demographics, medical and obstetric history, symptoms, laboratory data, therapy and pregnancy outcome. Statistical analysis was primarily descriptive; continuous variables were analyzed with t tests.RESULTS: A total of 20 cases of intrahepatic cholestasis of pregnancy were identified (0.32% of live births). All patients presented with pruritus. The mean gestational age at onset of symptoms was 31.1 weeks (range 13-38.4, median 32.4). Bile acids were measured in 18 cases and were elevated in all. The mean gestational age at delivery was 36.4 weeks (32.3-39.9). Eight patients were treated with ursodeoxycholic acid (600-1200 mg). All eight patients experienced subjective improvement in pruritus after initiation of treatment with ursodeoxycholic acid. Ursodeoxycholic acid was associated with a decrease in bile acids in most patients (p = 0.16) and with a significant decrease in serum transaminases (p = 0.03).CONCLUSIONS: Ursodeoxycholic acid is an effective therapy for relief of pruritus and improvement of the liver dysfunction that occurs with intrahepatic cholestasis of pregnancy.