输卵管开窗取胚术结合不同剂量MTX治疗异位妊娠效果及对患者CK、P、inhibin-A、PAPP-A影响  

Effect of embryo removed by salpingostomy combined with different doses of methotrexate for treating patients with ectopic pregnancy and Its influence on their levels of creatine kinase,progesterone,inhibin-A,pregnancy-associated plasma protein-A

作　　者：胡盛君 吴筱花 黄滢洁 HU Shengjun;WU Xiaohua;HUANG Yingjie(Yongkang Traditional Chinese Medicine Hospital, Zhejiang Province, 321300)

机构地区：[1]浙江省永康市中医院,321300

出　　处：《中国计划生育学杂志》2021年第8期1578-1581,共4页Chinese Journal of Family Planning

摘　　要：目的:分析输卵管开窗取胚术联合不同剂量MTX用药对异位妊娠(EP)恢复情况及CK、P、inhibin-A及PAPP-A水平的影响。方法:将本院2016年2月-2019年5月收治的EP患者84例依照随机信封法分为观察组及对照组各42例,对照组采用输卵管开窗取胚术联合低剂量MTX(25 mg)治疗,观察组采用输卵管开窗取胚术结合中等剂量MTX(50 mg)治疗。记录两组患者β绒毛膜促性腺激素(β-hCG)恢复正常时间、阴道停止出血时间、输卵管通畅情况;检测治疗前后患者血清磷酸肌酸激酶(CK)、孕酮(P)水平、抑制素-A(inhibin-A)及妊娠相关血浆蛋白A(PAPP-A)水平,统计治疗中出现的不良反应。结果:术后观察组β-hCG恢复正常时间(16.4±3.9d)及阴道停止出血时间(9.1±3.2d)均低于对照组(21.4±4.1d、12.8±3.3d),输卵管通畅程度优于对照组,血清中CK(61.29±10.93 U/L)、P(2.93±0.62 ng/ml)、inhibin-A(15.31±3.80 pg/ml)及PAPP-A(3.01±0.42 mU/L)均低于对照组,不良反应总发生率(16.7%)低于对照组(31.0%)(P<0.05)。结论采用输卵管开窗取胚术结合中等剂量MTX对EP患者干预后有助于加速患者恢复并改善患者血清CK、P、nhibin-A、PAPP-A水平。Objective:To investigate the effect of embryo removed by salpingostomy combined with different doses of methotrexate(MTX)for treating patients with ectopic pregnancy(EP),and to study its influence on the levels of creatine kinase(CK),progesterone(P),inhibin-A and pregnancy-associated plasma protein-A(PAPP-A)of the patients.Methods:84 patients with EP were enrolled and were randomly divided into two groups(42 cases in each group)by random envelope method from February 2016 to May 2019.The patients in control group had received low-dose MTX(25 mg)and embryo removed by laparoscopic salpingostomy,while the patients in observation group had received middle-dose MTX(50 mg)and embryo removed by laparoscopic salpingostomy.The recovery time ofβ-hCG level,stop time of vaginal bleeding,and fallopian tube patency rate of the patients were compared between groups.The levels of serum CK,P,inhibin-A,and PAPP-A of the patients in the two groups were recorded,and the adverse reactions rate of the patients in the two groups was analyzed.Results:The recovery time ofβ-hCG level(16.4±3.9d)and the stop time of vaginal bleeding(9.1±3.2d)of the patients in the observation group were significant lower than those(21.4±4.1d and 12.8±3.3d)of the patients in the control group,and the patency of the fallopian tube of the patients in the observation group was significant better than that of the patients in the control group.The levels of serum CK(61.29±10.93 U/L),P of the patients in the observation group was significant(2.93±0.62 ng/ml),inhibin-A(15.31±3.80 pg/ml),and PAPP-A(3.01±0.42 Mu/L)of the patients in the observation group were significant lower than those of the patients in the control group.The total incidence of adverse reaction(16.7%)of the patients in the observation group was significant lower than that(31.0%)of the patients in the control group(P<0.05).Conclusion:Application of embryo removed by salpingostomy combined with middle-dose MTX for treating the patients with EP can effectively promote the recovery,and improv

关 键 词：异位妊娠 输卵管开窗取胚术 中等剂量甲氨蝶呤 肌酸激酶 孕酮 抑制素-A 妊娠相关血浆蛋白A 

分 类 号：R71[医药卫生—妇产科学]