摘要
目的:系统评价低分子肝素治疗易栓症致反复自然流产的妊娠结局。方法:检索PubMed、Embase、Medline、Cochrane Library、CBM、CNKI、维普和万方数据库,查找有关低分子肝素治疗易栓症致反复自然流产的随机对照试验(RCT),检索时限均为各数据库自建库至2020年11月。纳入文献经数据提取和质量评价后,采用RevMan 5.3软件进行Meta分析。结果:最终纳入18篇RCT,共计1940例患者。Meta分析结果显示:与对照组相比,活产率明显升高(P<0.05),流产率、妊娠并发症发生率、胎儿生长发育异常及胎死宫内发生率及治疗后D-二聚体水平均明显降低(P<0.05),治疗后凝血酶时间明显延长(P<0.01),治疗后血清绒毛膜促性腺激素水平升高,其差异具有统计学意义(P<0.05);但在早产率方面,两组差异无明显统计学意义(P=0.38)。结论:当前证据显示,低分子肝素治疗易栓症致反复自然流产有明显疗效,但尚需进一步开展高质量、大样本、多中心的研究予以验证。
Objective:To systematically investigate the pregnancy outcome of recurrent spontaneous abortion caused by thrombophilia treated with low molecular weight heparin(LMWH).Methods:Randomized controlled trials(RCTs)about recurrent spontaneous abortion caused by thrombophilia treated LMWH were searched in databases including PubMed,Embase,Medline,Cochrane Library,CBM,CNKI,VIP and Wanfang from the date of establishment to November,2020.Meta-analysis was performed by RevMan 5.3 after data extraction and quality evaluation.Results:A total of 18 RCTs involving 1940 patients were included.The results of meta-analysis showed that the live birth rate was higher than that of the control group(P<0.05).The abortion rate,incidence of pregnancy complications,incidence of abnormal fetal growth and intrauterine fetal death and the level of D-dimer after treatment were significantly decreased compared with control group(P<0.05).After treatment,the thrombin time was significantly prolonged(P<0.01),and the serum HCG level was increased(P<0.05).But there was no significant difference in the preterm birth rate between the two groups(P=0.38).Conclusion:Results of this study showed that LMWH had obvious effect on recurrent spontaneous abortion caused by thrombophilia,which should be furtherly verified by more RCTs with high quality,large samples and multiple centers.
作者
孙旸
陈晓
付晓宇
刘冀琴
吴思雨
SUN Yang;CHEN Xiao;FU Xiao-yu;LIU Ji-qin;WU Si-yu(Department of Obstetric and Gynecologic,Characteristic Medical Center of Chinese People's Armed Police Force,Tianjin 300162,China;Department of Obstetric and Gynecologic,the 7^(th) Medical Center of Chinese PLA General Hospital,Beijing 100700,China;Clinical Laboratory,Characteristic Medical Center of Chinese People's Armed Police Force,Tianjin 300162,China)
出处
《中国药物应用与监测》
CAS
2021年第3期155-160,共6页
Chinese Journal of Drug Application and Monitoring
基金
国家自然科学基金项目(8170445)。
关键词
易栓症
反复自然流产
低分子肝素
META分析
妊娠结局
Thrombophilia
Recurrent spontaneous abortion
Low molecular weight heparin
Meta-analysis
Pregnancy outcome
