依诺肝素与磺达肝癸钠用于复发性流产患者妊娠期抗凝治疗的对比  

Comparison between enoxaparin and fondaparinux sodiumon anticoagulant therapy in pregnant patient with recurrent miscarriage

作　　者：郭仲杰 刘春霞 郭晓霞 张云 林暄 Guo Zhongjie;Liu Chunxia;Guo Xiaoxia;Zhang Yun;Lin Xuan(Department of Obstetric&Gynecology,The 3rd Affiliated Hospital of Guangdong pharmaceutical University,Guangzhou,Guangdong,510410,China;The Affiliate Reproductive Hospital of Sichuan Genitalia Hygiene Research Center,Chengdu,Sichuan,610032,China)

机构地区：[1]广东药科大学附属第三医院妇产科,广东广州510410 [2]四川省生殖健康研究中心附属生殖专科医院,四川成都610032

出　　处：《当代医学》2020年第30期5-8,共4页Contemporary Medicine

基　　金：四川省妇幼保健协会科研课题(2020YB09)。

摘　　要：目的通过对比依诺肝素与磺达肝癸钠用于复发性流产患者妊娠期抗凝治疗的妊娠结局和不良事件的发生率,探讨磺达肝癸钠在本领域的治疗效果。方法选取2017年12月至2018年12月本院收治的300例诊断为易栓症的复发性流产患者作为研究对象。根据治疗方法的不同分为依诺肝素治疗组(n=220)与磺达肝癸钠治疗组(n=80)。比较两组妊娠结局以及不良事件发生率。结果两组均未发生子痫前期和胎盘早剥。两组活产率、FGR发生率、中期妊娠胎儿丢失率、再次发生早期妊娠自然流产率比较差异无统计学意义。依诺肝素治疗组新生儿体质量低于磺达肝癸钠治疗组,差异有统计学意义(P<0.05)。两组再次发生早期妊娠自然流产的患者胎儿绒毛染色体核型正常比例比较差异无统计学意义。依诺肝素治疗组注射部位皮肤反应、注射部位皮下淤斑血肿形成、转氨酶升高发生率均高于磺达肝癸钠治疗组,差异有统计学意义(P<0.05);两组口鼻黏膜出血、血小板减少、APTT延长、产后出血发生率比较差异无统计学意义。结论磺达肝癸钠用于复发性流产患者妊娠期抗凝治疗,不良反应少,值得临床推广使用。Objective To study the efficacy of fondaparinux sodium by comparing the difference of pregnancy outcomes and adverse events between enoxaparin and fondaparinux sodium in the anticoagulant therapy of pregnant patients with recurrent abortion.Methods 300 patients with recurrent abortion diagnosed as thrombophilia and treated in our department from December 2017 to December 2018 were selected as the study subjects.They were divided into enoxaparin treatment group(n=220)and fondaparinux sodium treatment group(n=80)according to different treatment methods.Pregnancy outcomes and adverse events between the two groups were compared.Results No preeclampsia and placental abruption occurred in either group.There was no statistically significant difference between the two groups in live birth rate,FGR incidence rate,fetal loss rate in mid-term pregnancy,and spontaneous abortion rate in early pregnancy recurrence.The neonatal body weight of the enoxaparin treatment group was lower than that of the fondaparinux sodium treatment group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the normal proportion of the villus karyotype between the two groups of patients with spontaneous abortion in early pregnancy.The incidence of skin reactions at the injection site,the incidence of subcutaneous ecchymosis and hematoma formation at the injection site,and the incidence of elevated transaminases were higher in the enoxaparin treatment group than in the fondaparinux sodium treatment group(P<0.05).There was no significant difference in the incidence of oro-nasal mucosal bleeding,incidence of thrombocytopenia,prolonged APTT,and incidence of postpartum hemorrhage between the two groups.Conclusion Fondaparinux sodium can be used in the anticoagulant therapy of pregnant patients with recurrent abortion,and its adverse events are less,which is worth popularizing in clinical practice.

关 键 词：复发性流产 依诺肝素 磺达肝癸钠 

分 类 号：R714.21[医药卫生—妇产科学]