主动免疫联合地屈孕酮治疗复发性自然流产的疗效及对患者血清LP、ADPN水平的影响  

Therapeutic Efficacy of Active Immunization Combined with Dydrogesterone in the Treatment of Recurrent Abortion and Its Effects on Serum Levels of LP and ADPN

作　　者：马春燕[1] 张晓勇[1] 丁桂凤 MA Chunyan;ZHANG Xiaoyong;DING Guifeng(Dept.of Gynecology,Jinan Third People’s Hospital,Jinan 250101,China;Urumqi Maternal and Child Health Care Hospital,Urumqi 830004,China)

机构地区：[1]济南市第三人民医院妇产科,济南250101 [2]乌鲁木齐市妇幼保健院,乌鲁木齐830004

出　　处：《中国药房》2018年第20期2836-2839,共4页China Pharmacy

基　　金：新疆维吾尔自治区自然科学基金资助项目(No.201442137-18)

摘　　要：目的:观察主动免疫联合地屈孕酮治疗复发性自然流产的疗效及对患者血清瘦素(LP)、脂联素(ADPN)水平的影响。方法:选择2015年11月-2016年11月济南市第三人民医院妇产科收治的103例复发性自然流产孕妇作为试验组,并按照入院先后顺序分为试验1组(n=51)和试验2组(n=52);另选择100例正常妊娠孕妇作为对照组。试验1组受试者给予主动免疫联合地屈孕酮治疗,即提取患者配偶的淋巴细胞注射到患者皮下,每次间隔半个月,主动免疫3次为1个疗程;妊娠后给予地屈孕酮片10mg,bid,服药至妊娠后3个月。试验2组患者给予地屈孕酮片10 mg,bid,服药至妊娠后3个月。比较入组时试验组与对照组的血清β-人绒毛膜促性腺激素(β-HCG)、LP、ADPN水平及治疗后两个试验组上述血清指标水平和妊娠结局(再次流产、足月妊娠、成功分娩率)。结果:入组时,试验组受试者的血清β-HCG、LP、ADPN水平均显著低于对照组;治疗后,试验1组的β-HCG、LP、ADPN水平,足月妊娠率及成功分娩率均显著高于试验2组,再次流产率显著低于试验2组(P<0.05)。研究中未观察到有明显不良反应发生。结论:采用主动免疫联合地屈孕酮治疗复发性自然流产,可显著提高孕妇的血清LP、ADPN水平,改善妊娠结局,且安全性较高。OBJECTIVE:To observe the therapeutic efficacy of active immunization combined with dydrogesterone in the treatment of recurrent abortion,and its effects on serum levels of leptin(LP)and adiponectin(ADPN).METHODS:Totally 103 patients with recurrent abortion from department of gyhecology,Jinan Third People’s Hospital during Nov.2015 to Nov.2016 were selected as trial group,and then divided into trial group one(n=51)and trial group two(n=52)according to admission order.Other 100 normal pregnant women were taken as control group.Trial group one was given active immunization combined with dydrogesterone,including that lymphocytes from the patients’spouse were injected subcutaneously into the patient,every half a month,3 times of active immunization as a course of treatment,and was given Dydrogesterone tablet 10 mg after pregnancy,bid,until 3 months after the pregnancy.Trial group two was given Dydrogesterone tablet 10 mg,bid,until 3 months after the pregnancy.The serum levels ofβ-HCG,LP and ADPN were compared between trial group and control group at admission,the serum levels ofβ-HCG,LP,ADPN and pregnancy outcome(recurrent abortion,full-term pregnancy and successful delivery rate)was compared between 2 trial groups after treatment.RESULTS:At admission,the serum levels ofβ-HCG,LP and ADPN in trial group were significantly lower than control group.After treatment,the levels ofβ-HCG,LP and ADPN,successful delivery rate and full-term pregnancy rate in trial group one were significantly higher than trial group two,recurrent abortion rate was significantly lower than trial group two,with statistical significance(P<0.05).No adverse reactions were observed in the study.CONCLUSIONS:The use of active immunization combined with dydrogesterone can significantly improve the serum levels of LP and ADPN as well as pregnancy outcome,with good safety.

关 键 词：主动免疫 地屈孕酮 复发性自然流产 疗效 瘦素 脂联素 

分 类 号：R714[医药卫生—妇产科学] R284.2[医药卫生—临床医学]