低分子肝素联合阿司匹林治疗抗磷脂抗体引起的复发性流产的临床效果分析

doi:10.3969/j.issn.1006-6233.2018.03.019

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摘要 目的: 分析探讨低分子肝素联合阿司匹林治疗抗磷脂抗体引起的复发性流产的临床疗效。方法: 选取我院2015年12月至2017年12月收治的88例抗磷脂抗体引起的复发性流产患者进行研究,采用随机双盲法分为对照组(n=44)和观察组(n=44),对照组和观察组患者分别采用单用阿司匹林治疗和低分子肝素联合阿司匹林治疗,比较两组患者的临床治疗效果。结果: 治疗后,观察组和对照组患者临床治疗后活产率分别为88.64%、65.91%,组间相比差异具有统计学意义(χ²=6.47,P<0.05);观察组和对照组患者妊娠期并发症发生率,组间相比差异无统计学意义(P>0.05);经治疗后,两组患者E2、P激素表达水平均显著改善,但观察组患者的改善效果显著优于对照组,组间差异具有统计学意义(P<0.05);治疗后,观察组患者IFN-γ、IL-4以及IFN-γ/IL-4水平均显著优于对照组(P<0.05)。结论: 抗磷脂抗体引起的复发性流产患者采用低分子肝素联合阿司匹林治疗的临床效果显著,且有助于患者激素水平的表达和免疫力的提升,同时有助于改善患者的妊娠结局,安全性较高,值得临床推广。

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	张书筠
	张弘
	王云洁
	丁佳琦

关键词 ：低分子肝素, 阿司匹林, 抗磷脂抗体, 复发性流产

Abstract：Objective: To investigate the clinical efficacy of low molecular weight heparin combined with aspirin in the treatment of recurrent spontaneous abortion caused by antiphospholipidantibodies. Methods: 88 patients with recurrent spontaneous abortion caused by anti-phospholipid antibody were selected from December 2015 to December 2017 in our hospital. Patients were divided into control group (n = 44) and observation group (n = 44) The patients in the control group and observation group were treated with aspirin and low molecular weight heparin together with aspirin, respectively. The clinical effects of the two groups were compared. Results: After treatment, the total effective rate in the observation group and the control group after treatment was 88.64% and 65.91%, respectively. The difference between the two groups was statistically significant (χ⁼ 6.47, P <0.05). The observation group and the control group were pregnant There was no significant difference in the incidence of complications among the two groups (P> 0.05). After treatment, E2 and P levels in both groups were significantly improved, but the improvement in observation group was significantly better than that in control group (P <0.05). After treatment, the levels of IFN-γ, IL-4 and IFN-γ / IL-4 in the observation group were significantly better than those in the control group (P <0.05). Conclusion: Low molecular weight heparin combined with aspirin in patients with recurrent spontaneous abortion caused by antiphospholipid antibodies has a significant clinical effect, which is helpful for the expression of the hormone and the enhancement of immunity in patients, and also helps to improve the pregnancy outcome of patients with high safety. It is worth clinical promotion.

Key words： Low molecular weight heparin Aspirin Antiphospholipid antibodies Recurrent pregnancy loss

基金资助:江苏省卫计委面上课题,(编号:H2017065);江苏省卫生厅资助基金项目,(编号:201501065)

通讯作者: 张弘

引用本文:

张书筠, 张弘, 王云洁, 丁佳琦. 低分子肝素联合阿司匹林治疗抗磷脂抗体引起的复发性流产的临床效果分析[J]. 河北医学, 2018, 24(3): 422-426.
ZHANG Shuyun, ZHANG Hong, WANG Yunjie, et al. Clinical Analysis of Low Molecular Weight Heparin and Aspirin in Treating Recurrent pregnancy loss Caused by Antiphospholipid Antibodies. HeBei Med, 2018, 24(3): 422-426.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2018.03.019 或 http://www.hbyxzzs.cn/CN/Y2018/V24/I3/422

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