低分子肝素治疗血栓前状态导致的复发性流产患者的疗效和血栓弹力图的应用价值  

Curative effect of low molecular weight heparin in treatment of patients with recurrent spontaneous abortion induced by prethrombotic state and the application value of thrombelastogram

作　　者：卢雪景[1] 秦丽欣 梁建梅[1] 刘晓旭[1] 赵会娟 申林林 王亚凡[1] LU Xue-Jing;QIN Li-Xin;LIANG Jian-Mei(Shijiazhuang Municipal Maternal and Child Health Care Hospital,Shijiazhuang,Hebei 050000,China)

机构地区：[1]石家庄市妇幼保健院,河北石家庄050000

出　　处：《中国妇幼保健》2021年第16期3761-3764,共4页Maternal and Child Health Care of China

基　　金：河北省医学科学研究重点课题计划(20191418)。

摘　　要：目的分析低分子肝素(LMWH)治疗血栓前状态导致的复发性流产(RSA)患者的疗效及血栓弹力图(TEG)的应用价值。方法选取2017年1月-2019年10月石家庄市妇幼保健院收治的血栓前状态导致的80例RSA患者,随机分为对照组(40例,采取常规治疗)和观察组(40例,采取常规治疗联合LMWH治疗)。比较两组患者妊娠结局、D-二聚体水平、TEG参数及不良反应发生率。结果观察组保胎成功率为92.50%,对照组保胎成功率为70.00%,两组比较差异有统计学意义(χ^(2)=6.646,P<0.05)。治疗后,观察组和对照组D-二聚体水平分别为(0.41±0.11)mg/L和(0.71±0.07)mg/L,两组比较差异有统计学意义(t=-14.690,P<0.05)。治疗后,观察组R值、MA值及CI值分别为(7.10±0.50)min、(60.52±2.90)mm及(1.40±0.62);对照组R值、MA值及CI值分别为(3.77±0.69)min、(69.03±3.92)mm及(3.02±0.40)。两组治疗后R值、MA值及CI值比较差异均有统计学意义(t=24.652,t=-11.056,t=-13.891,均P<0.05)。观察组和对照组不良反应发生率分别为10.00%和12.50%,两组比较,差异无统计学意义(χ^(2)=0.125,P>0.05)。结论 LMWH治疗血栓前状态导致的RSA的疗效显著,能够改善患者的血栓前状态和妊娠结局,提高保胎成功率,动态监测TEG可为RSA患者的治疗提供参考,并指导LMWH用药。Objective To analyze the curative effect of low molecular weight heparin(LMWH) in treatment of patients with recurrent spontaneous abortion(RSA) induced by prethrombotic state and the application value of thrombelastogram(TEG).Methods From January 2017 to October 2019,80 patients with RSA induced by prethrombotic state treated in Shijiazhuang Municipal Maternal and Child Health Care Hospital were selected and randomly divided into control group(40 cases,conventional therapy) and observation group(40 cases,conventional therapy combined with LMWH). The pregnancy outcomes,the levels of D-dimer,TEG parameters,and incidence rates of adverse reactions in the two groups were compared.Results The tocolysis successful rate in observation group and control group were 92.50% and 70.00%,respectively,there was statistically significant difference(χ^(2)=6.646,P<0.05). After treatment,the levels of D-dimer in observation group and control group were(0.41±0.11)mg/L and(0.71±0.07)mg/L,respectively,there was statistically significant difference(t=-14.690,P<0.05). After treatment,R value,MA value,and CI value in observation group were(7.10±0.50) minutes,(60.52±2.90) mm,and(1.40±0.62),respectively;R value,MA value,and CI value in control group were(3.77±0.69) minutes,(69.03±3.92) mm,and(3.02±0.40),respectively. There were statistically significant differences in R value,MA value,and CI value between the two groups(t=24.652,t=-11.056,t=-13.891,P<0.05).The incidence rates of adverse reactions in observation group and control group were 10.00% and 12.50%,respectively,there was no statistically significant difference(χ^(2)=0.125,P>0.05).Conclusion Curative effect of LMWH in treatment of patients with RSA induced by prethrombotic state is significant,the therapy can improve prethrombotic state and pregnancy outcome,increase tocolysis successful rate,dynamic monitoring of TEG can provide reference for treatment of RSA and direct application of LMWH.

关 键 词：低分子肝素 复发性流产 血栓弹力图 

分 类 号：R714.21[医药卫生—妇产科学]