四种方案治疗不明原因复发性流产的临床疗效分析

发布时间：2018-01-30 18:52

本文关键词： 不明原因复发性流产(URSA) 淋巴细胞免疫治疗阿司匹林人绒毛膜促性腺激素(hCG) 联合治疗　出处：《中华生殖与避孕杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的探讨淋巴细胞免疫治疗(lymphocyte immunotherapy,LIT)联合阿司匹林和/或注射用人绒毛膜促性腺激素(human chorionic gonadotropin,h CG)治疗不明原因复发性流产(unexplained recurrent spontaneous abortion,URSA)的临床疗效及安全性。方法回顾性分析2009年1月1日—2014年12月31日就诊、病历资料完整且LIT结束后1年内妊娠的URSA患者的临床资料,比较单纯LIT(A组,n=61)、LIT联合阿司匹林(B组,n=109)、LIT联合hCG(C组,n=35)、LIT联合hCG及阿司匹林(D组,n=65)的妊娠成功率、活产率,分析妊娠结局的影响因素,并监测孕期并发症及随访出生儿情况。结果妊娠成功率B组为75.2%、C组为82.9%、D组为83.1%均显著高于A组(59.0%,P0.05),活产率B组为71.6%、C组为82.9%、D组为80.0%,均显著高于A组(55.7%,P0.05),B组、C组、D组的妊娠成功率及活产率组间无统计学差异(P0.05),但D组发生孕期并发症的风险(7.69%)相对增加(A~C组分别为0.00%、0.92%、0.00%)。结论 LIT联合阿司匹林、LIT联合hCG、LIT联合h CG及阿司匹林较单纯LIT治疗URSA可明显提高妊娠成功率及活产率,联合治疗值得在临床上应用及推广,但LIT联合hCG及阿司匹林的孕期安全性需进一步评估。
[Abstract]:Objective to investigate lymphocyte immunotherapy in lymphocyte immunotherapy. Lite combined with aspirin and / or human chorionic gonadotropin for injection of human chorionic gonadotropin. H CGR) was used to treat unexplained recurrent spontaneous abortion of unexplained recurrent abortion. Methods the clinical efficacy and safety of Ursa were retrospectively analyzed from January 1st 2009 to December 31st 2014. The clinical data of URSA patients with complete medical records and pregnancy within 1 year after the end of LIT were compared with those in LIT(A group (61L / LIT combined with aspirin B). The pregnancy success rate, live delivery rate and the influencing factors of pregnancy outcome were analyzed in LIT combined with hCG(C group with hCG and Aspirin D group. Results the success rate of pregnancy in group B was 75.2% and that in group C was 82.9%, 83.1% in group D was significantly higher than that in group A (59.0%). The rate of live birth in group B was 71.6% and that in group C was 82.9%, which was significantly higher than that in group A (55.7%) and group C (group C). There was no significant difference in pregnancy success rate and live delivery rate among group D (P 0.05), but the risk of complications during pregnancy in group D was 7.69%.) the relative increase in group A was 0.00%. Conclusion LIT combined with aspirin Lit and hCG. Compared with LIT alone, LIT combined with hCG and aspirin can significantly improve the success rate of pregnancy and the rate of live delivery. The combined therapy is worth applying and popularizing in clinic. However, the safety of LIT combined with hCG and aspirin during pregnancy needs to be further evaluated.
【作者单位】：北京大学第三医院生殖医学中心;
【基金】：国家自然科学基金(30671971)~~
【分类号】：R714.21
【正文快照】： 复发性流产(recurrent spontaneous abortion,h CG、LIT联合h CG及阿司匹林的妊娠结局,并RSA)是指连续≥2次失败的临床妊娠[1],RSA患监测母胎并发症。者遭受了身体和心理上的双重创伤。一直以来,目前尚无LIT联合阿司匹林、LIT联合h CG研究者们致力于寻找相关病因及有效治疗。

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