临床医药实践
臨床醫藥實踐
림상의약실천
PROCEEDING OF CLINICAL MEDICINE
2015年
1期
22-25
,共4页
抗心磷脂抗体阳性早孕复发性流产%绒毛膜促性腺激素%阿司匹林联合激素药物%临床价值
抗心燐脂抗體暘性早孕複髮性流產%絨毛膜促性腺激素%阿司匹林聯閤激素藥物%臨床價值
항심린지항체양성조잉복발성유산%융모막촉성선격소%아사필림연합격소약물%림상개치
anticardiolipin antibody positive pregnancy recurrent miscarriage%chorionic gonadotropin%aspirin combined hormone drugs%clinical value
目的：探讨阿司匹林联合激素类药物治疗抗心磷脂抗体阳性早孕复发性流产的疗效，为优化抗心磷脂抗体阳性早孕复发性流产治疗方案提供依据。方法：选择2012年8月—2013年8月收治的早孕复发性流产患者72例。在保障患者知情权的基础上，根据患者自愿分为观察组和对照组，各36例。在确定妊娠到妊娠3个月期间，对照组肌肉注射绒毛膜促性腺激素每日1000~2000 U。观察组在对照组的基础上，在确定妊娠后，口服阿司匹林和泼尼松直至抗心磷脂抗体监测连续两次阴性停止服药。随访1年，了解患者妊娠情况和分娩结局。结果：观察组痊愈、有效和无效例数分别有26，3和7例，痊愈率和总有效率为72.2%和80.6%，痊愈率和总有效率显著高于对照组（χ2分别为19.835和18.627，P <0.05）。观察组恶心、腹痛、头痛、疲倦、过敏性皮疹分别有1，0，0，2，1例，不良反应发生率为11.1%，与对照组相比差异无统计学意义（χ2＝2.567，P >0.05）。观察组完全依从、基本依从和不依从例数分别为28，6和2例，依从率为94.4%。观察组治疗依从率显著高于对照组（χ2＝6.203，P <0.05）。结论：抗心磷脂抗体阳性早孕复发性流产患者在绒毛膜促性腺激素治疗基础上，行阿司匹林联合激素类药物治疗可以提高妊娠的成功率，改善妊娠结局，避免流产、早产，获得更好的治疗依从性，在临床中具有重要的运用价值。
目的：探討阿司匹林聯閤激素類藥物治療抗心燐脂抗體暘性早孕複髮性流產的療效，為優化抗心燐脂抗體暘性早孕複髮性流產治療方案提供依據。方法：選擇2012年8月—2013年8月收治的早孕複髮性流產患者72例。在保障患者知情權的基礎上，根據患者自願分為觀察組和對照組，各36例。在確定妊娠到妊娠3箇月期間，對照組肌肉註射絨毛膜促性腺激素每日1000~2000 U。觀察組在對照組的基礎上，在確定妊娠後，口服阿司匹林和潑尼鬆直至抗心燐脂抗體鑑測連續兩次陰性停止服藥。隨訪1年，瞭解患者妊娠情況和分娩結跼。結果：觀察組痊愈、有效和無效例數分彆有26，3和7例，痊愈率和總有效率為72.2%和80.6%，痊愈率和總有效率顯著高于對照組（χ2分彆為19.835和18.627，P <0.05）。觀察組噁心、腹痛、頭痛、疲倦、過敏性皮疹分彆有1，0，0，2，1例，不良反應髮生率為11.1%，與對照組相比差異無統計學意義（χ2＝2.567，P >0.05）。觀察組完全依從、基本依從和不依從例數分彆為28，6和2例，依從率為94.4%。觀察組治療依從率顯著高于對照組（χ2＝6.203，P <0.05）。結論：抗心燐脂抗體暘性早孕複髮性流產患者在絨毛膜促性腺激素治療基礎上，行阿司匹林聯閤激素類藥物治療可以提高妊娠的成功率，改善妊娠結跼，避免流產、早產，穫得更好的治療依從性，在臨床中具有重要的運用價值。
목적：탐토아사필림연합격소류약물치료항심린지항체양성조잉복발성유산적료효，위우화항심린지항체양성조잉복발성유산치료방안제공의거。방법：선택2012년8월—2013년8월수치적조잉복발성유산환자72례。재보장환자지정권적기출상，근거환자자원분위관찰조화대조조，각36례。재학정임신도임신3개월기간，대조조기육주사융모막촉성선격소매일1000~2000 U。관찰조재대조조적기출상，재학정임신후，구복아사필림화발니송직지항심린지항체감측련속량차음성정지복약。수방1년，료해환자임신정황화분면결국。결과：관찰조전유、유효화무효례수분별유26，3화7례，전유솔화총유효솔위72.2%화80.6%，전유솔화총유효솔현저고우대조조（χ2분별위19.835화18.627，P <0.05）。관찰조악심、복통、두통、피권、과민성피진분별유1，0，0，2，1례，불량반응발생솔위11.1%，여대조조상비차이무통계학의의（χ2＝2.567，P >0.05）。관찰조완전의종、기본의종화불의종례수분별위28，6화2례，의종솔위94.4%。관찰조치료의종솔현저고우대조조（χ2＝6.203，P <0.05）。결론：항심린지항체양성조잉복발성유산환자재융모막촉성선격소치료기출상，행아사필림연합격소류약물치료가이제고임신적성공솔，개선임신결국，피면유산、조산，획득경호적치료의종성，재림상중구유중요적운용개치。
Objective:To investigate the efficacy of aspirin combined hormone therapy anticardiolipin antibody - positive recurrent miscarriage in early pregnancy,provide the basis for optimizing pregnancy anticardiolipin antibody treatment of recur-rent miscarriage. Methods:patients with recurrent pregnancy miscarriage from August 2012 to August 2013 in hospital were 72 cases for the object. On the basis of protection of the patient's right to know,on the basis of voluntary patients divided into two groups and the control group of 36 cases. In determining pregnancy to pregnancy three - month period,the control group were injected daily human chorionic gonadotrophin 1 000 ~ 2 000 U. Observation group on the basis of the control group,after confir-ming the pregnancy,oral aspirin and anti - cardiolipin antibodies prednisone until two consecutive negative stop medication mo-nitoring. Follow 1 year,understand the patient pregnancy and birth outcomes. Results:The cure,the number of valid and invalid cases were 26,3,7 cases,recovery rate and the total effective rate of 72. 2% and 80. 6% cure rate and total effective rate was significantly higher(χ2 was respectively 19. 835 and 18. 627,P < 0. 05). Observation group,nausea,abdominal pain,headache, fatigue,allergic skin rashes have 1,0,0,2,1 cases of adverse reactions was 11. 1% ,compared with no significant difference(χ2= 2. 567 with the control group,P > 0. 05). Fully comply with the observation group,the basic compliance and non - compli-ance from the number of cases there were 28,6 and 2 cases,compliance rate was 94. 4% . Observation group was significantly higher treatment compliance rate(χ2 = 6. 203,P < 0. 05). Conclusion:The anti - cardiolipin antibodies in patients with recur-rent miscarriage in early pregnancy positive hCG treatment based on line aspirin hormone therapy can improve the success rate of pregnancy,to improve pregnancy outcomes,avoid miscarriage,premature birth,get better treatment compliance,has important value in clinical use,worthy of promotion.
