RESUMO
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 (P0. 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.
RESUMO
Objective To investigate the efficacy of S-adenosy-L-methionine (SAMe) combided with LMWH in the treatment of intrahepatic cholestasis of pregnancy. Methods 47 patients with intrahepatic cholestasis of pregnancy were divided into two groups:A group(n = 21)received a combination of SAMe and LMWH,B group(n = 26)received only SAMe.The symptom of itching and serum biochemical indexes,including TBA,TB,ALT,and AST were observed after 7days,and the pregnancy outcome between the two groups were compared after delivery. Results All the patients had a significant improvement in pruritus and TBA,TB,ALT,and AST(P ＜0.01＝.After 7 days,there were significant differences in prurits,FBA,AST,ALT,in receiving combination of SAMe and LMWH comparing with received SAMe alone(P ＜0.05＝.The incidence of amniotic fluid pollution was significantly different between the two groups(P＜0.01＝. Conclusion In women with intrahepatic cholestasis of pregnancy,combination of SAMe and LMWH were safe and efficient in the near future.