阿司匹林对早期复发性流产患者子宫血液动力学的作用

发布时间：2018-01-24 22:55

  本文关键词： 早期复发性流产 阿司匹林 子宫动脉血流 子宫内膜血流 子宫内膜容受性　出处：《上海交通大学学报(医学版)》2017年04期 　论文类型：期刊论文

【摘要】：目的·研究早期复发性流产(ERSA)患者黄体中期子宫血流参数特征,观察阿司匹林对子宫血液动力学的作用。方法·采用经阴道彩色多普勒超声检测271例有ERSA史妇女(ERSA组)和66例无反复自然流产史妇女(对照组)的黄体中期子宫内膜厚度和子宫血流参数。ERSA组予阿司匹林50 mg/d口服2个月及个体化治疗,观察其对子宫血流参数及再次妊娠的早期妊娠结局的影响。结果·ERSA组黄体中期子宫内膜厚度显著小于对照组,而内膜血流搏动指数(PI)、子宫动脉平均PI(m PI)、平均阻力指数(m RI)和平均收缩期峰值流速/舒张末期流速(m S/D)均显著高于对照组(均P0.05)。阿司匹林治疗2个月后,ERSA组子宫血流阻力明显改善(P=0.000),且对于子宫内膜厚度7 mm的患者,用药后子宫内膜厚度增加,差异有统计学意义(P=0.000)。ERSA组中163例完成阿司匹林治疗2个月后的子宫血流参数复测,其中136名患者经个体化治疗后再次妊娠,其中97名患者妊娠≥12周,10名患者于妊娠12周内再次流产,29名患者早期妊娠结局尚无法确定。结论·ERSA患者黄体中期子宫血流阻力较正常育龄妇女显著增加,内膜厚度较薄。阿司匹林可改善ERSA患者的子宫血流灌注,有利于早期妊娠结局的改善。
[Abstract]:Objective: to study the characteristics of uterine blood flow parameters in patients with early recurrent abortion (ERSA). To observe the effect of aspirin on uterine hemodynamics. Methods: 271 women with history of ERSA and 66 women with no history of recurrent spontaneous abortion were examined by transvaginal color Doppler ultrasound. ERSA group was given aspirin 50 mg/d orally for 2 months and individualized treatment. Results: the endometrial thickness in ERSA group was significantly lower than that in control group, while the endometrial blood flow pulsatility index (Pi) was significantly lower in the ERSA group than in the control group. Uterine artery mean PI(m Pi). The mean resistance index (mRI) and the mean peak systolic velocity / end-diastolic velocity (MS / D) were significantly higher than those in the control group (P < 0.05). After 2 months of aspirin therapy, the mean resistance index was significantly higher than that in the control group (P < 0.05). The uterine blood flow resistance in ERSA group was significantly improved, and the endometrial thickness increased in patients with endometrial thickness of 7 mm. There were significant differences in uterine blood flow parameters of 163 patients in the Pu 0.000U. ERSA group after 2 months of aspirin therapy. 136 patients were pregnant again after individualized treatment. Among them, 97 patients with pregnancy 鈮，

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