目的 探討S-腺苷蛋氨酸聯(lián)合熊去氧膽酸治療妊娠期肝內(nèi)膽汁淤積癥（ICP）的臨床療效及對肝功能、炎癥因子的影響。方法 將100例ICP患者隨機分為2組各50例，對照組僅予熊去氧膽酸單藥治療，觀察組在對照組的基礎上聯(lián)用S-腺苷蛋氨酸治療。比較兩組治療前后的瘙癢評分、肝功能指標、血清白介素-12（IL-12）和IL-18水平變化及妊娠結局。結果 治療后觀察組瘙癢評分明顯低于對照組，差異有統(tǒng)計學意義（P<0.05）。觀察組血清總膽紅素（TBIL）、總膽汁酸（TBA）、丙氨酸氨基轉(zhuǎn)移酶（ALT）、天冬氨酸氨基轉(zhuǎn)移酶（AST）水平明顯低于對照組，差異有統(tǒng)計學意義（P<0.05）；白細胞介素（IL）-12、IL-18水平明顯低于對照組，差異有統(tǒng)計學意義（P<0.05）。觀察組早產(chǎn)、羊水污染Ⅱ度、新生兒Apgar評分≤ 7分的發(fā)生率明顯低于對照組，差異有統(tǒng)計學意義（P<0.05）。結論 S-腺苷蛋氨酸聯(lián)合熊去氧膽酸治療ICP療效優(yōu)越，可顯著改善患者的肝功能及血清炎癥因子水平，改善妊娠結局。

Objective To explore the effect of Ursodeoxycholic acid (UDCA) combined with S-adenosyl-L-methionine (SAMe) in the treatment of intrahepatic cholestasis of pregnancy (ICP) and its effect on liver function and inflammatory factors.Methods 100 patients with ICP were randomly divided into two groups, 50 case in each group, and the control group were only treated with UDCA,and the observation group were treated with SAMe on the basis of the control group. Pruritus score, liver function, serum interleukin -12 (IL-12) and IL-18 level before and after treatment and pregnancy outcome in the two groups were compared.Results After treatment, pruritus score of the observation group was significantly lower than that of the control group (P< 0.05). The levels of TBil, TBA, ALT and AST of the observation group were significantly lower than those in the control group (P< 0.05), and the levels of IL-12 and IL-18 were significantly lower than those of control group (P< 0.05).The incidence rates of premature birth, amniotic fluid pollution degree, Apgar score ≤ 7 of the observation group of were significantly lower than those of the control group (P< 0.05).Conclusions UDCA combined with SAMe in the treatment of ICP is superior, and can improve the liver function and serum inflammatory factors, and improve the outcome of pregnancy.