泼尼松、环孢素A治疗反复自然流产患者的疗效及对患者妊娠结局、血清性激素水平和免疫功能的影响  

Effect of Prednisone and Cyclosporine A on Pregnancy Outcome,Serum Sex Hormone and Immune Function in Treatment of Patients with Recurrent Spontaneous Abortion

作　　者：吴虹 李红花 WU Hong;LI Honghua(Department of Obstetrics and Gynecology,Jiangning District Maternal and Child Health and Family Planning Service Center,Nanjing Jiangsu 211100)

机构地区：[1]南京市江宁区妇幼保健计划生育服务中心妇产科,江苏南京211100 [2]南京市江宁区淳化街道方山社区卫生服务中心妇产科,江苏南京211100

出　　处：《医学临床研究》2025年第3期453-455,459,共4页Journal of Clinical Research

摘　　要：【目的】探讨泼尼松、环孢素A治疗反复自然流产(recurrent spontaneous abortion,RSA)患者的疗效及对患者妊娠结局、血清性激素和免疫功能的影响。【方法】选取2021年1月至2023年1月在两院诊治的102例RSA患者,随机分为观察组[采用泼尼松+环孢素A+黄体酮+人绒毛膜促性腺激素(HCG)+爱乐维药物治疗]和对照组(采用黄体酮+HCG+爱乐维药物治疗),每组51例。检测两组治疗前后血清促卵泡雌二醇(estradiol,E_(2))、孕酮(progesterone,P)、促黄体生成素(luteinizing hormone,LH)水平及CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+),比较两组再次流产率、足月妊娠率、早产成功分娩率、成功分娩率、并发症发生情况。【结果】治疗后,两组E_(2)、P、LH水平均高于治疗前,且观察组高于对照组,差异均有统计学意义(P<0.05);治疗后,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)较治疗前显著上升,CD8^(+)水平显著下降,且观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于对照组,CD8^(+)低于对照组,差异均有统计学意义(P<0.05)。观察组再次流产率低于对照组,足月妊娠、成功分娩率高于对照组(P<0.05)。观察组并发症总发生率为11.76%,与对照组的7.84%比较,差异无统计学意义(P>0.05)。【结论】泼尼松、环孢素A可有效调节RSA患者性激素水平和免疫功能,改善妊娠结局,且具有安全性。【Objective】To investigate the efficacy of prednisone and cyclosporine A in the treatment of recurrent spontaneous abortion(RSA)and the effects on pregnancy outcomes,serum sex hormones and immune function.【Methods】A total of 102 RSA patients diagnosed and treated in two hospitals from January 2021 to January 2023 were randomly divided into the observation group[treated with prednisone+cyclosporin A+progesterone+human chorionic gonadotropin(HCG)+Philovidian]and the control group(progesterone+HCG+philovidian),with 51 cases in each group.Serum levels of estradiol(E_(2)),progesterone(P),luteinizing hormone(LH),CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)were detected before and after treatment in both groups.The rate of re-abortion,full-term pregnancy,successful preterm delivery,successful delivery and complications were compared between the two groups.【Results】After treatment,E_(2),P and LH levels in both control and observation groups were higher than those before treatment,and levels of E_(2),P and LH in the observation group was higher than those in the control group,the differences were statistically significant(P<0.05).After treatment,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in both groups significantly increased,while CD8^(+)level significantly decreased compared with those before treatment;And CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group,while CD8^(+)was lower than that in the control group,with statistical significance(P<0.05).The rate of repeated abortion in the observation group was lower than that in the control group,and the full-term pregnancy and successful delivery rates were higher than those in control group(P<0.05).The total incidence of complications in the observation group was 11.76%,compared with 7.84%in the control group,there was no significant difference(P>0.05).【Conclusion】Prednisone and cyclosporin A can effectively regulate sex hormone levels and immune function in RSA patients,improve pregnancy outcomes,and have certain safety.

关 键 词：流产 习惯性 泼尼松 环孢菌素 妊娠结局 免疫学试验 

分 类 号：R714.2[医药卫生—妇产科学]