低分子肝素治疗抗磷脂综合征疗效及对骨代谢影响的探讨  

Study of Low Molecular Heparin on Women with Antiphospholipid Syndrome and its Influence of Bone Metabolism

作　　者：李萍[1,2] 朱付凡[1] 

机构地区：[1]中南大学湘雅二医院,湖南长沙410011 [2]长沙市妇幼保健院,湖南长沙410007

出　　处：《实用妇产科杂志》2008年第11期670-673,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:比较低分子肝素与强的松和阿司匹林治疗抗磷脂综合征(APS)的疗效及对骨代谢的影响,探讨低分子肝素是否能替代强的松和阿司匹林治疗APS。方法:将抗心磷脂抗体(ACA)阳性患者80例(已孕40例,未孕40例)随机分为研究组及对照组,每组为40例。研究组予以低分子肝素(克塞),对照组予以强的松与阿司匹林治疗,观察治疗后两组ACA转阴率,对血液流变学、骨代谢及妊娠结局的影响。结果:①随治疗时间延长,研究组与对照组ACA转阴率均增加,差异无统计学意义(P>0.05)。②研究组治疗前后抗酒石酸酸性磷酸酶(TRAP)浓度,差异均无统计学意义(P>0.05);对照组治疗前后,差异均有统计学意义(P<0.05),研究组治疗后TRAP浓度均比对照组上升幅度小,差异均有统计学意义(P<0.05)。③治疗后研究组与对照组妊娠成功率差异无统计学意义(P>0.05)。结论:低分子肝素治疗抗磷脂综合征,其ACA转阴率、妊娠结局与强的松和阿司匹林相当,降低血浆粘度优于强的松和阿司匹林,对骨代谢影响比强的松和阿司匹林小。Objective：To compare the therapeutic effect of low molecular heparin with prednisone plus aspidn on antiphospholipid syndrome and their influence on bone metabolism, hemorheology and pregnancy outcome. Methods; A prospective observational study included 40 patients （20 pregnant,20 unpregnant） with anticardiolipin antibody in the study group who received low-molecular heparin.The control group had 40 patients, （20 pregnancy patients,20 unpregnancy patients） received prednisone end aspirin. Pregnancy outcomes, negative rate of anticardlolipin antibody （ACA） and the influence of bone metabolism and hemorheology were compared using standard statistical tests. Results：（1）With the prolonged treatment the Clearance rate of anticardiolipin antibody raised up. There was no significant difference in the Clearance rate of anticardlolipin antibody after treatment between the study group and control group （ P 〉 0.05）. （2）The concentration of and tartrate-resistand acid phosphatase （TRAP） of the study group had no significant difference after treatment （ P〉 0.05）,there was significant different in control group （ P〈 0.05）.The concentration of TRAP of study group was lower than the control group after one course and two courses of treatment （ P 〈 0.05）. （3） No difference was noted for pregnancy outcomes between the study group end control group （ P 〉 0.05） .Conclusions：There was no significant difference in the Clearance rate of anticardiolipin antibody and preg- nancy outcomes between the therapy with low-molecular heparin end prednisone and aspirin. The therapy with lowmolecular heparin is better then prednisone and aspirin to cut down plasma viscosity. The influence of low-molecular heparin to bone metabolism was lower than prednisone and aspirin.

关 键 词：抗磷脂综合征 低分子肝素 血浆粘度 抗酒石酸酸性磷酸酶 血钙 

分 类 号：R714[医药卫生—妇产科学]