熊去氧胆酸治疗对妊娠期肝内胆汁淤积症患者妊娠结局的影响及不良妊娠结局危险因素分析OA

Objective:To analyze the impact of Ursodeoxycholic Acid treatment on the pregnancy outcome of intrahepatic cholestasis of pregnancy(ICP)and influencing factors of adverse pregnancy outcomes.Method:A total of 66 ICP patients admitted to Ruijin People's Hospital from April 2019 to April 2022 were selected as the research subjects.The patients were divided into the observation group(n=33)and the control group(n=33)using the medical record number table drawing method.The control group was treated with conventional regimens,while the observation group was treated with Ursodeoxycholic Acid on the basis of the control group.The liver function[alanine transaminase(ALT),total bile acid(TBA),and aspartate transaminase(AST)]of the two groups were compared before and after treatment;the improvement of clinical symptoms,clinical treatment effectiveness,and adverse pregnancy outcomes between the two groups of patients were compared;clinical data of patients with adverse pregnancy outcomes and normal pregnancy outcomes were compared,and the risk factors affecting pregnancy outcomes in ICP patients through logistic regression were analyzed.Result:After treatment,the ALT,TBA,AST,and itching scores of both groups of patients were significantly reduced,and compared with the control group,the ALT,TBA,AST and pruritus scores in the observation group were significantly lower(P<0.05);compared with the control group,the jaundice subsided time in the observation group was significantly earlier(P<0.05);the total effective rate of the control group was 78.79%(26 33),which was lower than 96.97%(32/33)of the observation group(P<0.05);compared with the control group,the gestational age of the observation group was significantly longer,and the neonatal Apgar score at 5 min after birth,postpartum hemorrhage,cesarean section rate,perinatal mortality rate,fetal distress rate and meconium-stained amniotic fluid rate were significantly lower(P<0.05).Patients with adverse pregnancy outcomes with ICP onset time≤34 weeks and total bile acid>40 μmol/L,and the proportion of patients treated with ademetionine 1,4-butanedisulfonate were higher than those of patients with normal pregnancy outcomes(P<0.05);ICP onset time≤34 weeks,total bile acid level at admission>40 μmol/L and ademetionine 1,4-butanedisulfonate treatment were risk factors for adverse pregnancy outcomes in ICP patients(P<0.05).Conclusion:Ursodeoxycholic Acid has a high clinical efficacy in treating ICP,significantly improving liver function and clinical symptoms,while reducing the occurrence of adverse pregnancy outcomes.The onset time and total bile acid levels,ademetionine 1,4-butanedisulfonate treatment of ICP patients are risk factors for pregnancy outcomes.