摘要
目的探讨黄体酮联合低分子肝素钠治疗复发性流产的疗效。方法将84例复发性流产患者随机分为对照组和观察组,各42例。对照组患者给予黄体酮肌肉注射治疗,观察组患者在对照组治疗的基础上加用低分子肝素钠注射液。记录两组患者的妊娠结局、主要症状消失的时间和不良反应发生情况,比较两组治疗前后的纤维蛋白降解产物、D-二聚体、纤维蛋白原、P选择素、β-人绒毛膜促性腺激素、孕激素水平。结果观察组患者的足月分娩婴儿存活率高于对照组,出血、腰酸坠胀、腹部疼痛等主要症状消失的时间均短于对照组(均P<0.05)。治疗后,观察组患者的纤维蛋白降解产物、D-二聚体、纤维蛋白原、P选择素均较对照组降低,β-人绒毛膜促性腺激素和孕激素均较对照组升高(均P<0.05)。两组患者的不良反应发生率差异无统计学意义(P>0.05)。结论黄体酮联合低分子肝素钠治疗复发性流产具有良好的协同保胎效果,有利于改善患者的妊娠结局,优化早期胚囊发育状态,且用药安全性良好,其机制可能与改善机体高凝状态有关。
Objective To investigate the efficacy of progesterone combined with low molecular heparin sodium for the treatment of recurrent abortion.Methods Eighty-four patients with recurrent abortion were randomly divided into control group and observation group,with 42 patients in each group.Patients in the control group were given intramuscular injection of progesterone,whereas patients in the observation group were given additional low molecular heparin sodium injection on the basis of the therapy in the control group.Pregnancy outcomes,duration for recovery from major symptoms,and incidence of adverse reactions were recorded in both groups,the levels of fibrin degradation products,D-dimer,fibrinogen,P-selectin,β-human chorionic gonadotropin and progesterone were compared between the two groups before and after treatment.Results The observation group obtained a higher survival rate of full-term birth,shorter duration for recovery from major symptoms such as bleeding,soreness of loins and lumbar distention,and abdominal pain in contrast with the control group(all P<0.05).After treatment,the observation group had decreased fibrin degradation products,D-dimer,fibrinogen and P-selectin,along with increasedβ-human chorionic gonadotropin and progesterone,as compared with the control group(all P<0.05).There was no statistically significant difference in incidence rate of adverse reactions between the two groups(P>0.05).Conclusion Progesterone combined with low molecular heparin sodium has a good synergistic effect on fetus preservation in patients with recurrent abortion,which is conducive to improving patients′pregnancy outcome,optimizing the development state of embryo sac in early stage,and achieving a favorable drug safety.The mechanism may be related to hypercoagulability improvement in the body.
作者
朱益静
符圆圆
孔彩霞
李淑萍
ZHU Yi-jing;FU Yuan-yuan;KONG Cai-xia;LI Shu-ping(Department of Gynecology,Changzhou Hospital of Traditional Chinese Medicine,Changzhou 213000,China)
出处
《广西医学》
CAS
2020年第6期698-702,共5页
Guangxi Medical Journal
关键词
复发性流产
黄体酮
低分子肝素钠
Recurrent abortion
Progesterone
Low molecular heparin sodium
