宫腔内灌注粒细胞集落刺激因子加注射低分子肝素钙在薄型子宫内膜反复种植失败不孕症中应用研究  

Intrauterine perfusion of granulocyte colony-stimulating factor and injection of low molecular weight heparin in patients with thin endometrium following repeated implantation failure:a clinical study

作　　者：土增荣[1] 王丽媛[1] 段瑞云[1] 白春梅 高瑞璠 田秀珠[1] 张红梅[1] 何玉洁[1] 王治鸿[1] Tu Zengrong;Wang Liyuan;Duan Ruiyun;Bai Chunmei;Gao Ruifan;Tian Xiuzhu;Zhang Hongmei;He Yujie;Wang Zhihong(Department of Reproductive Medicine,First Clinical Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第一医院生殖医学中心,太原030001

出　　处：《中国药物与临床》2020年第9期1435-1438,共4页Chinese Remedies & Clinics

基　　金：山西省重点研发计划(指南)项目(201603D321071)。

摘　　要：目的探讨宫腔内灌注粒细胞集落刺激因子(G-CSF)加注射低分子肝素钙对薄型子宫内膜反复种植失败(RIF)的不孕患者的临床应用价值。方法选取2016年1月至2018年6月在我院生殖中心进行体外受精-胚胎移植(IVF-ET)治疗的薄型子宫内膜反复种植失败的患者152例,随机分为3组,A组47例:宫腔灌注G-CSF;B组51例:宫腔灌注G-CSF加注射低分子肝素钙;C组54例:作为对照组,只进行一般治疗。比较各组间患者的子宫内膜厚度、子宫内膜血流阻力指数(RI)、搏动指数(PI)、周期取消率、胚胎种植率、临床妊娠率、早期流产率、异位妊娠率。结果A组、B组与C组相比子宫内膜厚度、RI、PI、胚胎种植率、临床妊娠率差异均有统计学意义(P<0.05)。B组与A组、C组相比,早期流产率明显降低,差异有统计学意义(P<0.05)。结论宫腔内灌注G-CSF能明显改善薄型子宫内膜反复种植失败的不孕患者的胚胎种植率及临床妊娠率,给予注射低分子肝素钙可以显著降低早期流产率。Objective To investigate the clinical value of intrauterine infusion of granulocyte colony stimulating factor(G-CSF)and injection of low molecular weight heparin calium in infertility patients with thin endometrium following repeated implantation failure(RIF).Methods Included in this study were 152 patients who with thin endometrium who received in vitro fertilization embryo transfer(IVF-ET)but experienced RIF in our hospital between January 2016 and June 2018.The subjects were randomized into three groups,including group A to receive intrauterine perfusion of G-CSF(n=47),group B to receive intrauterine perfusion of G-CSF and injection of low molecular weight heparin calium(n=51),and group C as controls to receive conventional care(n=54).Endometrial thickness,endometrial blood flow resistance integer(RI),pulse index(PI),cycle cancellation rate,embryo implantation rate,clinical pregnancy rate,abortion rate,and ectopic pregnancy rate were compared among groups.Results There were significant differences in endometrial thickness,RI,PI,cycle cancellation rate,embryo implantation rate and clinical pregnancy rate between groups A,B and C(P<0.05).Compared with groups A and C,the rate of early abortion in group B was significantly lower,with statistically significant difference(P<0.05).Conclusion Intrauterine perfusion of G-CSF may significantly improve the embryo implantation rate and clinical pregnancy rate among infertile patients with thin endometrium following repeated implantation failure.Injection of low molecular weight heparin calium may significantly reduce the early abortion rate.

关 键 词：粒细胞集落刺激因子 低分子肝素钙 薄型子宫内膜 胚胎植入 

分 类 号：R714.8[医药卫生—妇产科学]