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(P<0.05)。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P<0.05)。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P<0.05)。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(P>0.05)。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。
Objective To investigate the effect of low molecular weight heparin combined with active immunization on patients with recurrent spontaneous abortion and its influences of hemodynamics. Methods A total of 92 cases of recurrent spontaneous abortion patients were randomly divided into treatment group （46 cases） and control group （46 cases）. In control group, the lymphocytes of the patients＇ husbands were actively immunized. Aiter pregnancy confirmed with blood -human chorionic gonadotropin （13 - HCG ）, the patients were administered of proges- terone 40 mg, intramuscularly once a day until 14 weeks of gestation. The treatment group was treated with low molecular heparin calcium 5000 U, twice a day on the basis of control group until 24 h before termination of pregnancy. The clinical efficacy, the levels of 13 - HCG, progesterone and hemodynamics and the incidence of adverse drug reactions wereobserved before and after treatment. Results The clinical effective rate in treatment group was 95.65% （44 cases/46 cases）, had significant difference with that in control group, which was 76. 09% （35 cases/46 cases, P 〈0. 05）. After treatment, the levels of β - HCG in treatment group and control group were （6535.05 ± 54. 34）, （9845.50±86. 91 ）nmol·L-1, progesterone were （123.45 ±3. 79）, （93. 24 ±5. 18） nmol· L-1（all P 〈0. 05）. After treatment, the blood viscosity, whole blood low shear viscosity and plasma viscosity in treatment group were （5.98 ±0. 52）, （7. 68 ±0. 51 ）, （1.90 ± 0. 34 ） mPa · s, had significant difference with those in control group, which were （7.78 ± 0. 76 ）, （9. 18 ±0. 71 ）, （2. 30 ±0. 29） mPa · s （all P 〈0. 05）. In treatment group, there were 3 cases of erythema and itching in the injection site, 2 cases of temporary vaginal bleeding, the incidence of adverse drug reactions was 10. 87% （5 cases/ 46 cases）. There were 4 cases of erythema and itching in the injection site in control group, with incidence of 8. 70
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2017年第20期2020-2022,2050,共4页
The Chinese Journal of Clinical Pharmacology
基金
海南省自然科学基金资助项目(813265)
关键词
低分子肝素
主动免疫
复发性自然流产
血流动力学
low molecular weight heparin
active immunization
recurrent spontaneous abortion
hemodynamics
