低分子肝素联合主动免疫治疗复发性自然流产的临床研究

发布时间：2018-03-22 09:40

本文选题：低分子肝素　切入点：主动免疫　出处：《中国临床药理学杂志》2017年20期 　论文类型：期刊论文

【摘要】：目的观察低分子肝素联合主动免疫对复发性自然流产的临床疗效及对患者血流动力学的影响。方法将92例复发性自然流产患者根据随机数字表法随机分为试验组46例和对照组46例。对照组患者丈夫的淋巴细胞进行主动免疫,患者经查血β-绒毛膜促性腺激素(β-HCG)确认怀孕后,给予黄体酮40mg,每日1次,肌内注射,至妊娠14周。试验组在对照组的基础上给予低分子肝素钙5000 U,每天2次,皮下注射,直至终止妊娠前24 h。比较2组患者的有效率,治疗前后血β-HCG、孕酮和血流动力学水平变化及药物不良反应情况。结果试验组和对照组有效率分别为95.65%(44例/46例),76.09%(35例/46例),差异有统计学意义(P0.05)。治疗后,试验组和对照组β-HCG分别为(6535.05±54.34),(9845.50±86.91)m U·mL~(-1);孕酮分别为(123.45±3.79)(93.24±5.18)nmol·L-1,差异均有统计学意义(均P0.05)。治疗后,试验组全血高切黏度、全血低切黏度、血浆黏度分别为(5.98±0.52),(7.68±0.51),(1.90±0.34)m Pa·s,对照组分别为(7.78±0.76),(9.18±0.71),(2.30±0.29)m Pa·s,差异均有统计学意义(均P0.05)。试验组出现注射部位红斑、瘙痒3例,暂时性阴道出血2例,药物不良反应发生率为10.87%(5例/46例);对照组出现注射部位红斑、瘙痒4例,药物不良反应发生率为8.70%(4例/46例),差异无统计学意义(P0.05)。结论低分子肝素联合主动免疫对复发性自然流产的疗效显著,且可改善患者血流动力学。
[Abstract]:Objective to observe the clinical effect of low molecular weight heparin (LMWH) combined with active immunization on recurrent spontaneous abortion and its effect on hemodynamics. Methods 92 patients with recurrent spontaneous abortion were randomly divided into two groups according to random digital table method. 46 cases of control group and 46 cases of control group. After the pregnancy was confirmed by 尾 -HCG, 40 mg of progesterone was given intramuscularly to 14 weeks of gestation. The experimental group was given low-molecular-weight heparin calcium 5000 U, twice a day, subcutaneously, on the basis of the control group. To 24 hours before termination of pregnancy. Compare the effective rate of two groups of patients, Before and after treatment, the changes of serum 尾 -HCG, progesterone, hemodynamics and adverse drug reactions were observed. Results the effective rates of the trial group and the control group were 95.65g / 44 cases / 46 / 35 cases / / 46 cases, respectively. The difference was statistically significant (P 0.05). The 尾 -HCG of the test group and the control group were 6535.05 卤54.34, 9845.50 卤86.91 mmol / mL and 123.45 卤3.79 卤93.24 卤5.18)nmol L ~ (-1), respectively, and the difference was statistically significant (P0.055.After the treatment, the whole blood high shear viscosity and the whole blood low shear viscosity were significantly higher in the test group than in the control group. The plasma viscosity were 5.98 卤0.52mPa, 7.68 卤0.51mPa, 1.90 卤0.34mPa s, respectively, and those in the control group were 7.78 卤0.76mPa and 2.30 卤0.29mPa, respectively. There were significant differences between the two groups (all P 0.05). There were 3 cases of erythema, 3 cases of pruritus, 2 cases of temporary vaginal hemorrhage in the trial group. The incidence of adverse drug reactions was 10.87% in 5 cases and 46 cases in the control group, while in the control group there were erythema at injection site and pruritus in 4 cases. The incidence of adverse drug reactions was 8.70% in 4 / 46 cases with no significant difference (P 0.05). Conclusion low molecular weight heparin combined with active immunization is effective in the treatment of recurrent spontaneous abortion and can improve hemodynamics.
【作者单位】：儋州市第一人民医院妇产科;海口市妇幼保健院妇产科;
【基金】：海南省自然科学基金资助项目(813265)
【分类号】：R714.21

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