低分子肝素皮下注射与小剂量阿司匹林和保胎灵胶囊联合应用于不明原因复发性流产的临床研究  

Clinical study of subcutaneous injection of low-molecular weight heparin combined with low-dose aspirin and Baotailing capsules in the treatment of unexplained recurrent spontaneous abortion

作　　者：张蓉[1] 周磊清 刘冬萍[1] 刘仙[1] 宣毅飞[1] ZHANG Rong;ZHOU Lei-qing;LIU Dong-ping;LIU Xian;XUAN Yi-fei(Department of Gynecology and Obstetrics,the 184th Hospital of Yingtan Liberation Army,Yingtan 334500,China)

机构地区：[1]鹰潭市解放军第184医院妇产科,江西鹰潭334500

出　　处：《实用药物与临床》2018年第10期1170-1173,共4页Practical Pharmacy and Clinical Remedies

基　　金：鹰潭市科技计划项目(SF201721)

摘　　要：目的探讨低分子肝素皮下注射与小剂量阿司匹林、保胎灵胶囊联合应用于不明原因复发性流产(RSA)的临床疗效。方法选择我院妇产科2016年10月至2017年10月收治的86例不明原因RSA患者为研究对象。随机分为对照组和观察组,各43例。所有患者经临床确诊妊娠后辅以黄体酮、叶酸及维生素E等常规治疗,观察组给予低分子肝素皮下注射^+口服小剂量阿司匹林及保胎灵胶囊治疗;对照组给予口服小剂量阿司匹林及保胎灵胶囊治疗,比较两组患者治疗后妊娠结局、血清激素水平、凝血指标、免疫功能、用药期间不良反应及并发症情况。结果观察组患者平均分娩孕周较对照组延长(t=2.518,P=0.014),活产率高于对照组(P=0.019),两组流产率及足月产率比较差异无统计学意义(P> 0.05)。两组患者治疗前E2、β-HCG、PLT、APTT、DD、CD4^+、CD8^+、CD4^+/CD8^+水平比较差异无统计学意义(P> 0.05);治疗后,患者E2、β-HCG、CD8^+水平均升高(P <0.05),D-D、CD4^+、CD4^+/CD8^+水平降低(P <0.05),而治疗前后PLT、APTT水平比较差异无统计学意义(P> 0.05);治疗后,观察组E2、β-HCG、CD8^+水平高于对照组(P <0.05),D-D、CD4^+、CD4^+/CD8^+水平低于对照组(P <0.01)。两组患者用药期间不良反应及妊娠并发症发生率比较差异无统计学意义(P> 0.05)。结论低分子肝素皮下注射与小剂量阿司匹林、保胎灵胶囊联合应用,可有效改善不明原因RSA患者体内孕激素水平、凝血及免疫功能,改善妊娠结局,临床疗效显著。Objective To evaluate the clinical efficacy of low-molecular weight heparin （LMWH） combined with low-dose aspirin and Baotailing capsules in the treatment of unexplained recurrent spontaneous abortion （RSA）. Methods Totally 86 cases of unexplained RSA treated in our hospital from October 2016 to October 2017 were selected as the research subjects. They were randomly divided into control group and observation group, 43 cases in each group. After the clinical diagnosis of pregnancy, all patients were treated with progesterone, folic acid and vitamin E;in addition, observation group was treated with subcutaneous injection of LWMH and oral low-dose aspirin and Baotailing capsules;control group was given aspirin and Baotailing capsules. The pregnancy outcome, serum hormone level,blood coagulation index, immune function, adverse reaction and complications during the treatment were compared between the two groups. Results Compared with control group, the average pregnancy week in observation group was longer （ t = 2.518, P = 0. 014 ） , and the survival rate was higher （ P = 0. 019 ） ; there was no significant difference in abortion rate or term yield between the two groups （P 〉 0. 05 ）. There was no significant difference in the levels of E2, β-HCG, PLT,APTT,D-D, CD4^＋ , CD8^＋ or CD4^＋/CD8^＋ between the two groups before treatment （ P 〉 0. 05 ）. After treatment,the levels of E2, β-HCG and CD8^＋ increased significantly （P 〈 0.05）, while the levels of D-D,CD4^＋ and CD4^＋/CD8^＋ decreased significantly （P 〈 0. 05 ） , but there was no significant difference in the levels of PLT or APTT before and after treatment;the levels of E2, β-HCG and CD8^＋ in observation group were higher than those in control group （P 〈 0. 05 ） , while the levels of D-D, CD4^＋ and CD4^ ＋/CD8^＋ were lower than those in control group （ P 〈 0. 01 ）. There was no significant difference in the incidence rate of adverse reactions or pregnancy complications between the two groups

关 键 词：复发性流产 低分子肝素 阿司匹林 保胎灵 

分 类 号：R714.21[医药卫生—妇产科学]