CAJ | 학술논문

目的：通过多中心研究探索天花粉蛋白与甲氨蝶呤对于子宫瘢痕妊娠的治疗效果。方法选取信阳市中心医院、郑州大学第二附属医院、驻马店市中心医院妇产科收治的子宫瘢痕妊娠患者共90例，采用随机数字表将其分为2组。对照组45例，给予甲氨蝶呤臀部肌注射，一次50 mg，并空腹服用米非司酮50 mg，2次/天，1周为1个疗程；实验组45例，予天花粉蛋白，肌肉注射1.2 mg/次，2次/天，同时口服布洛芬，0.6 g/d，1周为1个疗程。1个疗程结束后，对比治疗前后2组患者血清中孕酮、β-HCG水平，及患者用药后产生的副反应。结果治疗后孕酮水平均明显降低，且实验组血清中的孕酮水平较对照组降低显著，其差异具有统计学意义（P＜0.05）。治疗后血清β-HCG水平明显降低，且实验组血清中的β-HCG水平降低显著，其差异具有统计学意义（P＜0.05）。患者副反应比较中，实验组明显低于对照组，差异具有统计学意义（P＜0.05）。结论对于治疗子宫瘢痕妊娠，天花粉蛋白和甲氨蝶呤都有一定疗效，但天花粉蛋白对于降低血清中孕酮、β-HCG水平较甲氨蝶呤效果更加显著，用药之后天花粉蛋白组的副反应率低。
목적：통과다중심연구탐색천화분단백여갑안접령대우자궁반흔임신적치료효과。방법선취신양시중심의원、정주대학제이부속의원、주마점시중심의원부산과수치적자궁반흔임신환자공90례，채용수궤수자표장기분위2조。대조조45례，급여갑안접령둔부기주사，일차50 mg，병공복복용미비사동50 mg，2차/천，1주위1개료정；실험조45례，여천화분단백，기육주사1.2 mg/차，2차/천，동시구복포락분，0.6 g/d，1주위1개료정。1개료정결속후，대비치료전후2조환자혈청중잉동、β-HCG수평，급환자용약후산생적부반응。결과치료후잉동수평균명현강저，차실험조혈청중적잉동수평교대조조강저현저，기차이구유통계학의의（P＜0.05）。치료후혈청β-HCG수평명현강저，차실험조혈청중적β-HCG수평강저현저，기차이구유통계학의의（P＜0.05）。환자부반응비교중，실험조명현저우대조조，차이구유통계학의의（P＜0.05）。결론대우치료자궁반흔임신，천화분단백화갑안접령도유일정료효，단천화분단백대우강저혈청중잉동、β-HCG수평교갑안접령효과경가현저，용약지후천화분단백조적부반응솔저。
Objective To compare effect of trichosanthin and methotrexate in the treatment of uterine scar pregnancy by a multi-center study. Methods 90 uterine scar pregnancy patients were selected from department of obstetrics and gynecology,in xinyang central hospital,the second affiliated hospital of zhengzhou university,zhumadian central hospital,using random number table divided into 2 groups.The control group of 45 cases were treated by methotrexate,gluteal muscle injection,50 mg one time,and took mifepristone 50 mg,two times a day,a week for a course of treatment;45 cases in the experimental group,were treated with trichosanthin,intramuscular injection of 1.2 mg/time,two times a day,and oral administration of bloven,0.6 g/d,a week for a course of treatment.The end of a course of treatment,2 groups of patients before and after treatment were compared of the serum progesterone level,β-HCG,side reactions after treatment.Results After treatment,progesterone levels were significantly reduced,and the experimental group levels were lower than the control group obviously,the difference has statistical significance(P<0.05).Serum -HCG level after the treatment significantly reduced,and the experimental group in serum -HCG levels were significantly lower,with statistical difference (P <0.05 ). Comparison of adverse reaction of the patients,the experimental group was obviously lower than control group,with statistically significant difference (P<0.05).Conclusion For the treatment of uterine scar pregnancy,trichosanthin and methotrexate have certain effect,but trichosanthin could lower serum progesterone,β-HCG levels more significantly than methotrexate,trichosanthin group side reaction rate is low.