黄体酮治疗先兆流产有效性的真实世界研究  

Study on the efficacy of progesterone in the treatment of threatened abortion:a real world study

作　　者：张琳[1] 林建昌[2] 肖大立[3] 邓贵华[1] ZHANG Lin;LIN Jianchang;XIAO Dali;DENG Guihua(Department of Pharmacy,Women and Children Hospital of Guangdong Province,Guangzhou 510010,China;Supervision Office,Women and Children Hospital of Guangdong Province,Guangzhou 510010,China;Medical Department,Women and Children Hospital of Guangdong Province,Guangzhou 510010,China)

机构地区：[1]广东省妇幼保健院药学部,广东广州510010 [2]广东省妇幼保健院监察室,广东广州510010 [3]广东省妇幼保健院医务科,广东广州510010

出　　处：《广东药科大学学报》2021年第5期120-123,共4页Journal of Guangdong Pharmaceutical University

摘　　要：目的运用真实世界研究方法(real world study,RWS)探讨黄体酮治疗先兆流产临床应用情况。方法通过医院信息系统(HIS)和临床合理用药监测系统(PASS)对2019年9月-2020年9月我院住院部收治的先兆流产患者的基本信息、用药情况、给药途径、孕酮数值、妊娠结局等信息进行登记和提取。根据患者的风险状态及其生物物理学表现,将患者分为观察组(本次妊娠宫颈管缩短或有复发性流产史)和对照组,比较两组患者使用黄体酮后的妊娠结局以及不同孕周、不同剂型对治疗效果的影响。结果活产率比较:分娩孕周>34周观察组有527例(占55.5%),对照组有442例(占46.1%),差异有统计学意义(P=0.035);分娩孕周<34周观察组有92例(占9.7%),对照组有86例(占9.0%),差异无统计学意义(P=0.080)。自然流产率比较:观察组有171例(占18.0%),对照组有260例(占27.1%),差异有统计学意义(P=0.024)。妊娠10~24周使用黄体酮自然流产率最低(占21.8%),差异有统计学意义(P=0.038)。不同的黄体酮疗程结果比较,用药4周的患者,分娩孕周>34周的活产率达到71.5%,高于用药1周和2周的活产率(P<0.01)。3种剂型应用结果显示,肌注黄体酮治疗的患者最多,自然流产率最低(占12%),但不同给药途径对妊娠结局和症状缓解时间的影响差异无统计学意义(P>0.05)。结论黄体酮可降低本次妊娠宫颈管缩短或有复发性流产史的先兆流产患者的流产率,不同孕周给药的治疗效果存在差异,本研究为黄体酮临床合理应用提供了依据。Objective To explore the clinical application of progesterone in the treatment of threatened abortion by real world study method.Methods The real data research method was adopted to register and extract the basic information,medication,route of administration,progesterone value,pregnancy outcome and other information of threatened abortion patients in our hospital from September 2019 to September 2020 through hospital information system(HIS)and clinical rational drug use monitoring system(PASS).According to the risk status and biophysical manifestations of the patients,they were divided into the observation group(cervical canal shortening or recurrent abortion history)and the control group.The pregnancy outcomes of the two groups after using progesterone and the effects of different gestational weeks and dosage forms on the treatment effect were compared.Results Comparison of live birth rate:there were 527 cases(55.5%)with gestational weeks above 34 weeks in the observation group and 442 cases(46.1%)with gestational weeks above 34 weeks in the control group;92 cases(9.7%)with gestational weeks below 34 weeks in the observation group and 86 cases(9.0%)with gestational weeks below 34 weeks in the control group.Comparison of spontaneous abortion rate:171 cases(18.0%)in the observation group and 260 cases(27.1%)in the control group,the difference was statistically significant(P=0.024).The rate of spontaneous abortion was the lowest(21.8%)when progesterone was used at 10-24 weeks of gestation(P=0.038).Compared with the results of different progesterone treatment courses,the live birth rate of patients with gestational age above 34 weeks after four weeks treatment was 71.5%,which was higher than that of patients treated for one week and two weeks(P<0.01).The results of three dosage forms showed that intramuscular injection of progesterone was the most common treatment,and the rate of spontaneous abortion was the lowest(12%),but there was no significant difference in the effects of different administration routes on pre

关 键 词：先兆流产 黄体酮 真实世界研究 

分 类 号：R979.2[医药卫生—药品]