盐酸利托君联合硫酸镁对高龄二胎先兆流产患者免疫调节功能、性激素水平及母婴结局的影响  

Effect of ritodrine hydrochloride combined with magnesium sulfate on immune regulation function,sex hormone levels,and maternal-fetal outcomes in older second-child patients with threatened abortion

作　　者：郭利红[1] 魏彩芬 王芳[2] 沙晓星 董辉[3] GUO Lihong;WEI Caifen;WANG Fang;SHA Xiaoxing;DONG Hui(Department of Obstetrics and Gynecology,Handan Maternal and Child Health Hospital,Handan 056000,China;Department of Nursing,Affiliated Hospital of Hebei Engineering University,Handan 056002,China;Department of Genetics,Handan Maternal and Child Health Hospital,Handan 056000,China)

机构地区：[1]河北省邯郸市妇幼保健院产三科,河北邯郸056000 [2]河北工程大学附属医院护理部,河北邯郸056002 [3]河北省邯郸市妇幼保健院遗传科,河北邯郸056000

出　　处：《中国医科大学学报》2024年第10期893-899,共7页Journal of China Medical University

基　　金：河北省医学科学研究课题计划(20231932)。

摘　　要：目的探讨盐酸利托君联合硫酸镁对高龄二胎产妇先兆流产的治疗效果,并分析其可能的作用机制。方法选取2020年3月至2021年12月河北省邯郸市妇幼保健院产三科就诊的100例高龄二胎先兆流产患者,按照随机数字表法均分为对照组和观察组,每组50例。对照组在一般干预措施(卧床休息,给予间歇性吸氧、营养摄入及心理护理等)基础上采用硫酸镁治疗;观察组在一般干预措施基础上采用盐酸利托君联合硫酸镁治疗。比较2组治疗效果,治疗前后免疫调节功能指标[血清封闭抗体(BA)和抗心磷脂抗体(ACA)]、性激素[孕酮(P)、雌二醇(E2)、β-人绒毛膜促性腺激素(β-h CG)]、相关细胞因子[妊娠相关蛋白A(PAPP-A)、人类白细胞抗原G(HLA-G)、白细胞介素-10(IL-10)]水平、母婴结局及不良反应。结果观察组总有效率高于对照组(96%vs.80%,P<0.05)。与治疗前比较,2组治疗后血清BA阳性率显著升高,ACA阳性率显著下降(均P<0.05);而治疗后观察组血清BA阳性率高于对照组,ACA阳性率低于对照组(均P<0.05)。与治疗前比较,2组治疗结束时、治疗后2周血清P、E2、β-hCG、PAPP-A、HLA-G、IL-10水平均显著升高;治疗结束和治疗后2周性激素和相关细胞因子水平观察组均高于对照组(均P<0.05)。观察组保胎成功、足月分娩、自然分娩比例均高于对照组;而流产、早产、剖宫产、新生儿不良结局发生率均低于对照组(均P<0.05)。2组不良反应发生率比较差异无统计学意义(P<0.05)。结论盐酸利托君联合硫酸镁治疗高龄二胎产妇先兆流产效果显著,能改善母体免疫调节功能,调节性激素及PAPP-A、HLA-G、IL-10水平,减少不良母婴结局且不增加不良反应。Objective To explore the effect of ritodrine hydrochloride combined with magnesium sulfate in the treatment of threatened abortion in older patients with a second child and to analyze its possible mechanism of action.Methods From March 2020 to December 2021,100 older second-child patients with threatened abortion at Handan Maternal and Child Health Hospital were selected and divided into control and observation groups using a random number table method,with 50 cases in each group.The control group was treated with magnesium sulfate based on general intervention measures(bed rest,intermittent oxygen inhalation,nutrition intake,and psychological nursing),while the observation group was treated with ritodrine hydrochloride combined with magnesium sulfate based on general intervention measures.The treatment effects,immunoregulatory function indicators[serum blocking antibody(BA)and anticardiolipin antibody(ACA)],sex hormone levels[progesterone(P),estradiol(E2),β-human chorionic gonadotropin(β-hCG)]and related cytokines[pregnancy-associated plasma protein A(PAPP-A),human leukocyte antigen G(HLA-G),and interleukin-10(IL-10)]before and after treatment,as well as maternal and infant outcomes and adverse reactions were compared.Results The total efficacy rate was higher in the observation group than in the control group(96%vs.80%,P<0.05).Compared with before treatment,the serum BA-positivity rate significantly increased and the ACA-positivity rate significantly decreased in both groups after treatment(both P<0.05).However,after treatment the serum BA-positivity rate was higher in the observation group than in the control group,and the ACA-positivity rate was lower than that in the control group(both P<0.05).Compared with before treatment,the serum P,E2,β-hCG,PAPP-A,HLA-G,and IL-10 levels significantly increased at the end of treatment and 2 weeks after treatment in both groups.The levels of sex hormones and related cytokines in the observation group were higher than those in the control group at the end of treatment an

关 键 词：高龄产妇 二胎 先兆流产 盐酸利托君 硫酸镁 

分 类 号：R714.21[医药卫生—妇产科学]