Laatikainen T
Am J Obstet Gynecol. 1978 Nov 1;132(5):501-6. doi: 10.1016/0002-9378(78)90743-3.
Serum bile acid concentrations were followed in 29 patients with cholestasis of pregnancy treated for pruritus with either phenobarbital or cholestyramine. The response of serum cholic and chenodeoxycholic acid levels to phenobarbital administered to 10 patients in a 100 to 150 mg. daily dose was variable: some decrease was found in four and some increase in three of the patients, but no clear effect on itching could be seen in any of them. In five of the other 10 patients treated with cholestyramine, 4 Gm. two or three times a day, serum cholic and chenodeoxycholic acid levels fell within 1 week of treatment, in one of these near to normal with complete relief from pruritus. It seems that patients with initially high serum bile acid levels do not respond to cholestyramine treatment. In these cases the biliary excretion and enterohepatic circulation of bile acids may be diminished to such an extent that the anion-binding resin is unable to augment fecal elimination of bile salts sufficiently to lower their serum levels.
对29例妊娠胆汁淤积症且因瘙痒接受苯巴比妥或消胆胺治疗的患者进行了血清胆汁酸浓度监测。给10例患者每日服用100至150毫克苯巴比妥，血清胆酸和鹅去氧胆酸水平的反应各不相同：4例患者有所下降，3例患者有所上升，但均未对瘙痒产生明显效果。在另外10例接受消胆胺治疗的患者中，5例患者每天服用2至3次4克消胆胺，治疗1周内血清胆酸和鹅去氧胆酸水平下降，其中1例接近正常且瘙痒完全缓解。似乎初始血清胆汁酸水平较高的患者对消胆胺治疗无反应。在这些情况下，胆汁酸的胆汁排泄和肠肝循环可能减少到一定程度，以至于阴离子交换树脂无法充分增加粪便中胆盐的排泄以降低其血清水平。
