The effect of low molecular weight heparin in the treatment of patients with intrahepatic cholestasis pregnancy ;and regulation of cytokines / 中国基层医药

ABSTRACT

Objective To observe the effect of low molecular weight heparin in the treatment of patients with intrahepatic cholestasis pregnancy(ICP)and regulation of cytokines.Methods 124 patients with ICP were randomly divided into observation group and control group.The control group was treated with SAMe +UDCA therapy,the con-trol group was added low molecular weight heparin.All patients were treated for 10 days.Alanine aminotransferase (ALT),aspartate aminotransferase (AST),total bile acid (TBA),tumor necrosis factor alpha (TNF -α)and IL-18 were observed before and after treatment.Results After treatment,ALT,AST and TBA levels were lower in the two groups(t=64.48,110.14,45.75,40.76,62.54,24.67,all P=0.000),which of the observation group were higher(t=62.42,49.42,23.03,all P=0.000).After treatment,the TNF-αand IL-18 levels were lower in the two groups(t=13.14,25.07,all P=0.000),the TNF-αlevel in the observation group was lower than the control group(t=4.91,P=0.000).After treatment,the incidence rates of neonatal meconium,neonatal asphyxia of the observation group were significantly lower than those of the control group(7.14%vs.20.69%,χ2 =4.33,P=0.037;8.93% vs.24.14%,χ2 =4.75,P=0.029).The incidence rate of fetal and maternal hemorrhage between the two groups had no statistically significant differences (1.79% vs.1.72%,χ2 =0.00,P=0.980;5.17% vs.3.57%,χ2 =0.17,P=0.680).Conclusion The effect of low molecular weight heparin in the treatment of patients with intrahepatic cholestasis of pregnancy is exact,it can reduce the biochemical markers and inflammatory cytokine expression and improve perinatal outcome,which deserves to promote in the clinical treatment application.