法安明联合阿司匹林治疗不同类型高凝状态复发性流产疗效  

Effect of Dalteparin Plus Aspirin in Treating Different Hypercoagulable State of Clinical Recurrent Miscarriage

作　　者：卢阳 陈萍 林素仙 姜建昌 王胜男 张智勇 

机构地区：[1]温州市人民医院风湿免疫科,325000

出　　处：《医学研究杂志》2016年第12期109-111,共3页Journal of Medical Research

摘　　要：目的研究法安明联合阿司匹林在治疗高凝状态复发性流产中的价值，探讨不同类型高凝状态的疗效和并发症差异。方法选取2011年5月～2014年5月高凝状态[D-二聚体升高和（或）血小板聚集率升高]复发性流产患者283例，均推荐采用法安明联合阿司匹林治疗。剔除随访失败患者16例，共267例患者纳入研究，其中同意采用的患者共216例，拒绝采用该方案的患者共51例。此外根据高凝状态指标差异，将同意治疗患者分为D-二聚体升高组（HD）、血小板聚集率升高组（HP）、D-二聚体和血小板聚集率均升高组（HD＋HP）。同意治疗的患者，在排卵期准备同房前一天开始采用法安明（5000IU）联合小剂量阿司匹林（25mg）治疗。比较治疗组与对照组患者的妊娠结局的差异，同时分析治疗组患者各亚组间的妊娠结局和并发症的差别。结果治疗组和对照组的的妊娠成功率分别86．11％和43．13％，两组相比差异有统计学意义（P〈0．05）。治疗组组内比较发现，HD和HP组的妊娠成功率为91．25％和88．89％，两组比较差异有统计学意义（P〉0．05）。HD＋HP组的妊娠成功率为76．56％，与HD及HP组相比，差异有统计学意义（P〈0．05）。结论法安明联合阿司匹林是治疗高凝状态复发性流产的安全有效方法，其单纯D-二聚体升高或血小板聚集率升高患者的疗效优于两者均升高的患者。Objective To study the value of daheparin plus aspirin in treating different hypercoagulable state of clinical recurrent miscarriage ,and to explore differences of efficacy and complications in different types of hypercoagulable state. Methods We selected 283 cases of recurrent spontaneous abortion patients with hypercoagulable state [ D - dimer elevated or （and） increased platelet aggrega- tion] from May 2011 to May 2014. All were recommended dalteparin plus aspirin therapy. Excluding 16 patients followed up for failure, 267 patients were included in the study, in which 216 patients agreed to adopt the treatment plan,the 51 patient refused to adopt the the treatment plan. Additional, according to the difference of hypercoagulable state index, the patients of agreeing to treatment were divided in- to 3 groups： D -dimer elevated group（HD） , platelet aggregation elevated group （HP）, D -dimer and platelet aggregation rate elevated group （HD ＋ HP）. The patients who were consent to treatment, on the day before intercourse in ovulation, began using Fragmin （5000IU） combined with low -dose aspirin （25mg） treatment. The difference of pregnancy outcome between treatment group and control group was Compared, and simultaneously the differences of pregnancy outcome and complications among subgroups were analyzed. Results The pregnancy success rate of the treatment group was 86.11% , and the control group was 43.13%. There were significant differences between two groups（P 〈0.05）. Compared with the treatment group, the pregnancy success rate of the HD group was 91.25% , the HP group was 88.89% , and there were no significant differences between two groups（P 〉 0.05）. Then the pregnancy success rate of the HD ＋ HP group was 76.56% , compared with HD and HP group, there ware significant differences between two groups （P 〈 0.05 ）. Conclusion In treating recurrent miscarriage of hypercoagulable state, daheparin plus aspirin is safe and effective method, the efficacy of D - dimer or pl

关 键 词：复发性流产D-二聚体血小板聚集法安明 阿司匹林 

分 类 号：R5[医药卫生—内科学]