地屈孕酮片治疗黄体功能不全所致先兆流产疗效  

Efficacy and safety analysis of dydrogesterone tablets in the treatment of the patients with threatened abortion due to luteal phase defect

作　　者：陈俭勤 邓小中 姚周平 CHEN Jianqin;DENG Xiaozhong;YAO Zhouping(Jinhua Hospital Affiliated to Zhejiang University School of Medicine,Jinhua,Zhejiang Province,321000;Jinhua Maternal and Child Health Hospital,Zhejiang Province;Jinhua Ophthalmic Hospital,Zhejiang Province)

机构地区：[1]浙江大学医学院附属金华医院,321000 [2]浙江省金华市妇幼保健院 [3]浙江省金华市眼科医院

出　　处：《中国计划生育学杂志》2022年第12期2807-2811,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨地屈孕酮片治疗黄体功能不全(LPD)所致先兆流产(TA)的疗效及安全性。方法:选取2018年5月-2021年5月本院收治的LPD所致TA患者99例,随机数字表法分为地屈孕酮组(n=50)和对照组(n=49),分别予口服地屈孕酮片或肌注黄体酮治疗。疗程结束后评价疗效,记录两组症状缓解时间、不良反应发生率,测定治疗前后血清孕激素[血绒毛膜促性腺激素(β-hCG)、雌二醇(E_(2))、孕酮(P)]、细胞因子[肿瘤坏死因子α(TNF-α)、γ干扰素(IFN-γ)、白细胞介素10(IL-10)],并于疗程结束后随访至妊娠结束,比较两组妊娠结局。结果:保胎成功率地屈孕酮组(90.0%)与对照组(81.6%)无差异(P>0.05);地屈孕酮组阴道流血、腹痛腹胀、腰背酸痛及宫缩频繁等症状缓解时间均短于对照组(P<0.05);两组治疗后血清β-hCG、E_(2)、P、IL-10升高,而TNF-α、INF-γ降低,且地屈孕酮组血清E_(2)、P、IL-10高于对照组,TNF-α、INF-γ低于对照组(均P<0.05);地屈孕酮组不良反应(14.0%)、早产(2.0%)、胎膜早破(10.0%)发生率均低于对照组(30.6%、16.3%、23.5%)(均P<0.05)。结论:采用地屈孕酮片治疗LPD所致TA能有效提升患者血清性激素并改善细胞因子水平,促进临床症状迅速缓解,保胎成功率与肌注黄体酮相当,但不良反应更少,且对母儿影响小。Objective: To investigate the efficacy and safety of dydrogesterone tablets in the treatment of the patients with threatened abortion(TA) caused by luteal phase defect(LPD). Methods: A total of 99 patients with TA caused by LPD were selected and were divided into study group(n=50) and control group(n=49) by random number table method from May 2018 to May 2021. The patients in the study group were treated with oral dydrogesterone tablets and the patients in the control group were treated with intramuscular injection of progesterone. The curative effect of the patients in the two groups after treatment was evaluated. The symptom relief time and the incidence of adverse reactions of the patients in the two groups were recorded. The serum levels of progestational hormones, such as beta-human chorionic gonadotropin(β-hCG), estradiol(E_(2)), and progesterone(P), and the levels of cytokines, such as tumor necrosis factor alpha(TNF-α), interferon gamma(IFN-γ), and interleukin 10(IL-10) of the patients in the two groups before and after treatment were measured. The patients in the two groups after treatment were followed up till the end of pregnancy, and the pregnancy outcomes of the patients were compared between the two groups. Results: The success rates of miscarriage prevention of the patients in study group and control group were 90.0% and 81.6%, respectively, but without statistically significant differences(P>0.05). Compared with that of the patients in the control group, the time of relief vaginal bleeding, abdominal pain and distension, low back pain, or frequent uterine contraction of the patients in the study group was significantly shorter(P<0.05). After treatment, the levels of serum β-hCG, E_(2), P, and IL-10 of the patients in the two groups had increased significantly, while the levels of TNF-α and INF-γ of the patients in the two groups had decreased significantly.Meanwhile,the levels of serum E_(2),P,and IL-10of the patients in the study group were significantly higher than those of the patients in

关 键 词：先兆流产 黄体功能不全 地屈孕酮 细胞因子 性激素 不良反应 

分 类 号：R714.21[医药卫生—妇产科学]