阿司匹林联合泼尼松治疗复发性流产效果及对患者免疫平衡及妊娠结局影响  

Effect of aspirin combined with prednisone for treating patients with recurrent abortion and its influence on the immune balance and pregnancy outcomes

作　　者：敖明珠 于海华 AO Mingzhu;YU Haihua(Dalian Women's and Children's Medical Center(Group),Dalian,Liaoning Province,116000)

机构地区：[1]大连市妇女儿童医疗中心(集团),116000

出　　处：《中国计划生育学杂志》2023年第3期575-580,共6页Chinese Journal of Family Planning

基　　金：辽宁省自然基金计划项目(2019-MS-070)。

摘　　要：目的:探讨阿司匹林联合泼尼松治疗复发性流产效果及对患者免疫平衡及妊娠结局的影响。方法:前瞻性选取本院2018年1月-2020年1月收治的复发性流产患者82例,数字表法分为两组各41例,均接受阿司匹林治疗,联合组加用泼尼松治疗。对比两组治疗前后血清免疫因子水平、维生素D、凝血酶激活的纤溶抑制物(TAFI)水平及妊娠结局。结果:联合组治疗总有效率(97.7%)高于对照组(78.1%),妊娠成功率(80,5%)高于对照组(58.5%),早产率(24.4%)低于对照组(51.2%)(均P<0.05);两组胎盘早剥、胎膜早破、活产率无差异(P>0.05)。治疗后两组血清白细胞介素-2(IL-2)、IL-2/IL-10均下降,IL-10均上升且联合组IL-2(10.28±1.48pg/ml)、IL-2/IL-10(0.89±0.06)均低于对照组(12.95±1.74pg/ml、1.39±0.25),IL-10(11.85±1.48pg/ml)高于对照组(9.73±1.28pg/ml)(均P<0.05);两组活化凝血活酶时间(APTT)水平均上升,血小板(PLT)、纤维蛋白原(FIB)均下降,且联合组APTT(35.8±3.9s)水平高于对照组(33.81±3.16 s),PLT(153.67±20.24)10^(9)/L、FIB(2.54±0.15g/L)水平低于对照组(165.83±21.85)10^(9)/L、(2.69±0.35g/L);两组血清维生素D和TAFI均上升且联合组血清维生素D(45.71±2.85ng/ml)、TAFI(14.86±1.85μg/ml)水平均高于对照组(38.71±3.75ng/ml、12.75±1.74μg/ml)(均P<0.05)。对照组恶心呕吐1例、头晕1例,观察组恶心呕吐2例、下肢浮肿1例,两组总发生率(4.9%、7.3%)无差异,治疗期间两组均未出现严重不良反应,停药后明显缓解。结论:阿司匹林联合泼尼松治疗复发性流产可促进患者机体免疫平衡、改善妊娠结局,安全性较好。Objective:To explore the effect of aspirin combined with prednisone for treating patients with recurrent abortion,and to study its influence on the immune balance and pregnancy outcomes of these patients.Methods:82 patients with recurrent abortion were selected prospectively,and were divided into two groups by digital table method(41 cases in each group)from January 2018 to January 2020.The patients in the control group received treatment of aspirin,while the patients in the study group received treatment of aspirin combined with prednisone.The levels of serum immune factor,vitamin D,thrombine-activated fibrinolytic inhibitor(TAFD),and the pregnancy outcomes before and after treatment of the patients were compared between the two groups.Results:The total effective rate(97.7%)and the success rate of pregnancy(80.5%)of the patients in the study group were significantly higher than those(78.1%and 58.5%)of the patients in the control group.The rate of preterm birth(24.4%)of the patients in the study group was significantly lower than that(51.2%)of the patients in the control group(all P<0.05).There were no significant differences in the placental abruption,the premature rupture of membranes,and the live birth rates of the patients between the two groups(P>0.05).The serum interleukin-2(IL-2)levels and the IL-2/IL-10 value of the patients in both groups after treatment had decreased significantly,and the IL 10 level of the patients in both groups after treatment had increased significantly,and the IL-2 level(10.28±1.48pg/ml)and the IL-2/IL-10 value(0.89±0.06)of the patients in the study group after treatment were significantly lower than those(12.95±1.74pg/ml and 1.39±0.25)of the patients in the control group.The IL 10 level(11.85±1.48pg/ml)of the patients in the study group after treatment was significantly higher than that(9.73±1.28pg/m)of the patients in the control group(all P<0.05).The activated thrombin time(APTT)value of the patients in both groups after treatment had increased significantly,while the leve

关 键 词：复发性流产 阿司匹林 泼尼松 机体免疫平衡 血清维生素D 凝血酶激活的纤溶抑制物 妊娠结局 临床效果 

分 类 号：R714.21[医药卫生—妇产科学]