[1]李 欢,张 坤.不同黄体酮给药方式联合低分子肝素对不明原因复发性流产患者再次妊娠的影响对比研究[J].陕西医学杂志,2024,(8):1101-1105.[doi:DOI:10.3969/j.issn.1000-7377.2024.08.021]
　LI Huan,ZHANG Kun.Comparison of the effects of different progesterone administration methods combined with low molecular weight heparin on re-pregnancy in patients with unexplained recurrent spontaneous abortion[J].,2024,(8):1101-1105.[doi:DOI:10.3969/j.issn.1000-7377.2024.08.021]
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不同黄体酮给药方式联合低分子肝素对不明原因复发性流产患者再次妊娠的影响对比研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2024年8期
页码:
1101-1105
栏目:
药物与临床
出版日期:
2024-08-05

文章信息/Info

Title:
Comparison of the effects of different progesterone administration methods combined with low molecular weight heparin on re-pregnancy in patients with unexplained recurrent spontaneous abortion
作者:
李 欢; 张 坤
(西安市人民医院 西安市第四医院妇产科,陕西 西安 710004)
Author(s):
LI Huan; ZHANG Kun
(Department of Obstetrics and Gynecology,Xi'an People's Hospital,Xi'an 710004,China)
关键词:
不明原因复发性流产;  黄体酮;  低分子肝素;  妊娠;  人绒毛膜促性腺激素
Keywords:
Unexplained recurrent spontaneous abortion;  Progesterone;  Low molecular weight heparin;  Pregnancy;  Human chorionic gonadotropin
分类号:
R 714.21
DOI:
DOI:10.3969/j.issn.1000-7377.2024.08.021
文献标志码:
A
摘要:
目的:比较不同黄体酮给药方式联合低分子肝素治疗不明原因复发性流产再次妊娠的临床效果。方法:选取收治的不明原因复发性流产患者104例作为研究对象,根据随机数字表法将患者分为阴道给药组(52例)和肌肉注射组(52例)。两组患者均给予低分子肝素治疗,阴道给药组给予黄体酮阴道给药,肌肉注射组给予黄体酮肌肉注射。比较两组血清人绒毛膜促性腺激素(hCG)与孕酮水平、抗磷脂综合征相关指标、白细胞介素(IL)-10及IL-4水平、不良反应发生及妊娠情况。结果:接受治疗后,两组血清hCG、孕酮及IL-10、IL-4水平较治疗前升高,且阴道给药组高于肌肉注射组(均P<0.05)。接受治疗后,两组抗心磷脂抗体免疫球蛋白G(ACA-IgG)、狼疮抗凝物(LA)以及β2糖蛋白I(β2GPI)-IgG比治疗前降低,且阴道给药组低于肌肉注射组(均P<0.05)。阴道给药组不良反应总发生率低于肌肉注射组(P<0.05)。阴道给药组活产率高于肌肉注射组(P<0.05)。两组再次流产率及妊娠率比较差异无统计学意义(均P>0.05)。结论:对于既往不明原因复发性流产患者,再次妊娠后使用黄体酮阴道给药联合低分子肝素治疗可显著上调hCG与孕酮水平,调节免疫反应以改善母体排异作用及抗炎因子水平,提高活产率,且安全性良好。
Abstract:
Objective:To compare the clinical effects of different progesterone administration methods combined with low molecular weight heparin in the treatment of re-pregnancy with unexplained recurrent spontaneous abortion.Methods:A total of 104 patients with unexplained recurrent spontaneous abortion were selected and divided into vaginal administration group(52 cases)and intramuscular injection group(52 cases)according to the random number table method.Both groups were treated with low molecular weight heparin.The vaginal administration group was given progesterone vaginal administration,and the intramuscular injection group was given progesterone intramuscular injection.The levels of human chorionic gonadotropin(hCG),progesterone,antiphospholipid syndrome related indicators and interleukin-10(IL-10)and IL-4 levels,incidence of adverse reactions and pregnancy were compared.Results:After treatment,the levels of serum hCG,progesterone,IL-10 and IL-4 in the two groups were higher than those before treatment,and those in the vaginal administration group were higher than those in the intramuscular injection group(all P<0.05).After treatment,anticardiolipin antibody immunoglobulin G(ACA-IgG),lupus anticoagulant(LA)and β2-glycoprotein I(β2GPI)-IgG in the two groups were lower than those before treatment,and those in the vaginal administration group were lower than those in the intramuscular injection group(all P<0.05).The total incidence of adverse reactions in the vaginal administration group was lower than that in the intramuscular injection group(P<0.05).The live birth rate of the vaginal administration group was higher than that of the intramuscular injection group(P<0.05).There was no significant difference in the rate of re-abortion and pregnancy rate between the two groups(P>0.05).Conclusion:For patients with unexplained recurrent spontaneous abortion,vaginal administration of progesterone combined with low molecular weight heparin after re-pregnancy can significantly up-regulate hCG and progesterone levels,regulate immune response to improve maternal rejection and anti-inflammatory factor levels,and improve live birth rate,with good safety.

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备注/Memo

备注/Memo:
基金项目:陕西省重点研发计划项目(2017SF-062)
更新日期/Last Update: 2024-08-08