CAJ | 학술논문

目的：探究孕早期孕酮治疗对子宫内膜异位症（内异症）患者自然妊娠结局的影响。方法：将2008年1月-2012年1月内异症术后自然受孕、宫内单胎妊娠的120例孕妇按就诊顺序随机分成A组和B组，每组各60例；将同期正常宫内单胎妊娠的100例孕妇作为对照组（C组）。定期测定各组孕妇血清孕酮水平，A组中孕酮水平低于15 ng/mL者应用孕酮治疗，并根据血清孕酮水平调整孕酮剂量，比较3组孕妇的妊娠结局。结果：孕5～5＋6周，A、B组血清孕酮水平低于C组[（14．3±5．2） ng/mL、（15．1±4．9）ng/mL比（19．3±3．8）ng/mL]，P＜0．05；孕酮治疗后，A组血清孕酮水平明显升高；孕6～6＋6周始，A组和C组的孕酮水平差异无统计学意义（ P＞0．05），B组孕酮水平低于C组（ P＜0．05）；孕10～10＋6周始，3组孕妇的孕酮水平差异均无统计学意义（ P＞0．05）。B组孕妇孕早期胚胎停止发育发生率（11．7％）明显高于 A组（3．3％）、C组（5．0％），P＜0．05；3组孕妇稽留流产、死胎、胎儿畸形、早产发生率等差异无统计学意义。结论：内异症自然妊娠的孕妇，及时检测血清孕酮水平、及时补充孕酮，可以减少胚胎停止发育的发生率；孕5～10周可能是补充孕酮的最佳时间。
목적：탐구잉조기잉동치료대자궁내막이위증（내이증）환자자연임신결국적영향。방법：장2008년1월-2012년1월내이증술후자연수잉、궁내단태임신적120례잉부안취진순서수궤분성A조화B조，매조각60례；장동기정상궁내단태임신적100례잉부작위대조조（C조）。정기측정각조잉부혈청잉동수평，A조중잉동수평저우15 ng/mL자응용잉동치료，병근거혈청잉동수평조정잉동제량，비교3조잉부적임신결국。결과：잉5～5＋6주，A、B조혈청잉동수평저우C조[（14．3±5．2） ng/mL、（15．1±4．9）ng/mL비（19．3±3．8）ng/mL]，P＜0．05；잉동치료후，A조혈청잉동수평명현승고；잉6～6＋6주시，A조화C조적잉동수평차이무통계학의의（ P＞0．05），B조잉동수평저우C조（ P＜0．05）；잉10～10＋6주시，3조잉부적잉동수평차이균무통계학의의（ P＞0．05）。B조잉부잉조기배태정지발육발생솔（11．7％）명현고우 A조（3．3％）、C조（5．0％），P＜0．05；3조잉부계류유산、사태、태인기형、조산발생솔등차이무통계학의의。결론：내이증자연임신적잉부，급시검측혈청잉동수평、급시보충잉동，가이감소배태정지발육적발생솔；잉5～10주가능시보충잉동적최가시간。
Objective:To explore the effect of progesterone treatment during early pregnancy on natural pregnancy outcome in patients with endometriosis .Methods :A total of 120 postoperative endometriosis patients with single natural intrauterine preg-nancy from January 2008 to January 2013 were enrolled and randomly divided into Group A and Group B ,with 60 cases in each group .Meanwhile ,100 cases of normal single intrauterine pregnancy in the same period were enrolled as control group (Group C) .Serum progesterone levels were detected regularly in the three groups .Those who had lower progesterone levels (lower than 15 ng/mL) in Group A were treated with progesterone and the dose of progesterone was adjusted according to serum pro-gesterone level .Pregnancy outcomes of patients in the three groups were compared .Results:At 5~5+6 gestational weeks ,the progesterone levels of Group A and Group B were significantly lower than that of Group C [(14 .3 ± 5 .2)ng/mL、(15 .1 ± 4 .9) ng/mL vs .(19 .3 ± 3 .8)ng/mL] ,P<0 .05 .After progesterone treatment ,the serum progesterone level was significantly in-creased in Group A .At 6~6+6 gestational weeks ,no statistically significant difference in serum progesterone level was found between Group A and Group C (P>0 .05);serum progesterone level in Group B was signficantly lower than that in Group C (P<0 .05) .At 10~10+6 gestational weeks ,no statistically significant difference in serum progesterone level was found among the three groups (P> 0 .05) .The incidence of early embryonic diapause in Group B (11 .7% )was significantly higher than those in Group A (3 .3% ) and Group C (5 .0% ) ,P<0 .05 .No statistically significant differences in the incidences of abortion , stillbirth ,premature delivery and fetal malformation were found among the three groups .Conclusions :Detection of serum pro-gesterone level and replenishing of progesterone timely in the early natural pregnancy women with endometriosis can reduce em-bryonic diapauses .The optimal time to replenish progesterone may be at 5~10 gestational weeks .