地屈孕酮联合黄体酮对早期先兆流产患者性激素、免疫功能、阴道微生态及保胎效果的影响  

Effect of dydrogesterone combined with progesterone on sexual hormones,immune function,vaginal microbiota and fetal protection in patients with early threatened abortion

作　　者：章艳玲[1] ZHANG Yanling(Department of Gynaecology and Obstetrics,Huadu District People’s Hospital of Guangzhou,Guangzhou 510800,China)

机构地区：[1]广州市花都区人民医院妇产科,广州510800

出　　处：《西北药学杂志》2025年第1期200-204,共5页Northwest Pharmaceutical Journal

摘　　要：目的 评价地屈孕酮联合黄体酮对早期先兆流产(early threatened abortion,ETA)患者性激素、免疫功能、阴道微生态及保胎效果的影响。方法 选取ETA患者100例,根据治疗方法不同分为对照组(黄体酮治疗)和观察组(地屈孕酮联合黄体酮治疗),各50例。评价并比较2组的性激素[雌二醇(estradiol,E2)、孕酮(progesterone,P)]水平、血清免疫细胞因子[白细胞介素(interleukin,IL)-2、IL-4和γ-干扰素(interferon-γ,IFN-γ)]水平、阴道微生态及保胎效果等。结果 观察组的阴道出血消失时间[(4.01±0.93) d vs.(6.97±1.12) d]和腰腹部疼痛消失时间[(3.87±1.02) d vs.(6.34±1.10) d]显著短于对照组,保胎成功率(96.00%vs.78.00%)显著高于对照组(P<0.05)。2组患者治疗后血清E2和P水平以及外周血IL-4水平显著高于治疗前,IL-2和IFN-γ水平显著低于治疗前(P<0.05)。观察组治疗后血清IL-2[(2.27±0.28) ng·mL^(-1)vs.(3.26±0.46) ng·mL^(-1)]和IFN-γ[(1.26±0.26) ng·mL^(-1)vs.(1.56±0.21) ng·mL^(-1)]均显著低于对照组,E2[(1 114.73±94.40) ng·L^(-1)vs.(925.70±78.74) ng·L^(-1)]、P[(48.23±5.07) nmol·L^(-1)vs.(35.62±4.54) nmol·L^(-1)]、IL-4[(1.47±0.32) ng·mL^(-1)vs.(0.84±0.17) ng·mL^(-1)]均显著高于对照组(P<0.05)。观察组治疗后正常阴道微生态比例(94.00%vs.72.00%)、乳酸杆菌相对丰度[(74.64%±5.32%) vs.(65.35%±10.08%)]均显著高于对照组(P<0.05)。观察组和对照组不良反应发生率比较差异无统计学意义(12.00%vs.8.00%,P>0.05)。结论 地屈孕酮联合黄体酮能够促进ETA患者症状改善及性激素水平恢复,调节机体免疫功能及阴道微生态,提高保胎成功率,且安全性良好。Objective To evaluate the effects of dydrogesterone combined with progesterone on sexual hormones,immune function,vaginal microbiota and fetal protection in patients with early threatened abortion(ETA).Methods 100 ETA patients were selected and divided into a control group(treated with progesterone)and an observation group(treated with dydrogesterone and progesterone)based on different treatment methods,with 50 patients in each group.The levels of sex hormones[estradiol(E2)and progesterone(P)],serum immune cytokines[interleukin(IL)-2,IL-4,and interferon-γ(IFN-γ)],vaginal microbiota,and fetal protection effects were evaluated and compared between the 2 groups.Results The disappearance time of vaginal bleeding[(4.01±0.93)d vs.(6.97±1.12)d]and the disappearance time of waist and abdominal pain[(3.87±1.02)d vs.(6.34±1.10)d]in observation group were significantly shorter than that in control group,and the success rate of fetal protection(96.00%vs.78.00%)was significantly higher than control group(P<0.05).After treatment,the levels of serum E2 and P,as well as the proportion of peripheral blood IL-4 in both groups,were significantly higher than before treatment,while the proportions of IL-2 and IFN-γwere significantly lower than before treatment(P<0.05).After treatment,the serum IL-2[(2.27±0.28)ng·mL^(-1) vs.(3.26±0.46)ng·mL^(-1)]and IFN-γ[(1.26±0.26)ng·mL^(-1) vs.(1.56±0.21)ng·mL^(-1)]in observation group were significantly lower than in control group,while the E2[(1114.73±94.40)ng·L^(-1) vs.(925.70±78.74)ng·mL^(-1)],P[(48.23±5.07)nmol·L^(-1) vs.(35.62±4.54)nmol·L^(-1)],and IL-4[(1.47±0.32)ng·mL^(-1) vs.(0.84±0.17)ng·L^(-1)]were significantly higher than in control group(P<0.05).The proportion of normal vaginal microbiota(94.00%vs.72.00%)and relative abundance of lactobacilli(74.64%±5.32%vs.65.35%±10.08%)in observation group after treatment were significantly higher than that in control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the 2 g

关 键 词：早期先兆流产 地屈孕酮 黄体酮 性激素 保胎 

分 类 号：R984[医药卫生—药品]