醋酸阿托西班对高龄晚期先兆早产孕妇血清性激素与妊娠结局的影响
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摘要
目的探讨醋酸阿托西班对高龄晚期先兆早产孕妇血清性激素及妊娠结局的影响。方法选取2015年7月至2017年7月先兆早产的孕妇100例,随机分为对照组和观察组,各50例。对照组采用盐酸利托君治疗,观察组采用醋酸阿托西班治疗,两组在治疗前后分别抽取2 ml静脉血,检测血清中孕酮(P)、雌三醇(E3)水平,比较两组患者的疗效、不良反应、血清性激素和妊娠结局。结果治疗后,观察组48 h、7 d有效率均优于对照组(P=0.003,P=0.011)。观察组妊娠延长时间优于对照组(P=0.016)。观察组不良反应总发生率显著低于对照组(6.0%vs 30.0%,χ~2=9.756,P=0.001)。治疗后两组P水平均高于治疗前(P均<0.05),且观察组高于对照组(P=0.022);观察组E3水平较治疗前降低,对照组较治疗前未降反升,且两组比较差异有统计学意义(P=0.046)。治疗后观察组足月分娩率、新生儿存活均稍高于对照组(P=0.000,P=0.012),流产或早产率低于对照组,但无统计学差异(P=0.110)。结论醋酸阿托西班通过提高血清性激素中P水平、降低E3水平达到治疗高龄晚期先兆早产的目的,效果显著,不良反应少,安全性高,妊娠结局良好。
Objective To investigate the influence of atoxiban acetate on serum sex hormone and pregnancy outcome in advanced pregnant women with threatened preterm labor.Methods A total of 100 advanced pregnant women with threatened preterm labor from July 2015 to July 2017 were selected and divided into control group and observation group randomly(n=50,each).The control group patients received ritodrine hydrochloride treatment while the observation group patients received atoxiban treatment.Before and after treatment,2 ml venous blood was taken to detect the levels of progesterone(P) and estriol(E_3) in serum.The therapeutic effects,adverse reactions,serum sex hormones and pregnancy outcomes were compared between two groups.Results After the treatment,the effective rate of observation group was better than that of control group at 48 hours and 7 days(P=0.003,P=0.011).The prolongation time of pregnancy in observation group was longer than that in control group(P=0.016).The total incidence of adverse reactions in observation group was significantly lower than that in control group(6.0% vs 30.0%,χ~2=9.756,P=0.001).After treatment,P levels were higher in two groups(all P<0.05),and P level in observation group was higher than that in control group(P=0.022).The E3 level after treatment was lower in observation group and higher in control group than that before treatment(P<0.05).After treatment,the full-term delivery rate and neonatal survival rate of observation group were higher than those of control group(P=0.000,P=0.012),and the abortion or premature delivery rate was slightly lower than that of the control group,but there was no significant difference(P=0.110).Conclusions Atoxiban can improve the level of serum sex hormone P and reduce the level of E3 to achieve the goal of treating pregnant women with advanced premature delivery.The effect is remarkable,with fewer adverse reactions,high safety and good pregnancy outcomes.
Objective To investigate the influence of atoxiban acetate on serum sex hormone and pregnancy outcome in advanced pregnant women with threatened preterm labor.Methods A total of 100 advanced pregnant women with threatened preterm labor from July 2015 to July 2017 were selected and divided into control group and observation group randomly(n=50,each).The control group patients received ritodrine hydrochloride treatment while the observation group patients received atoxiban treatment.Before and after treatment,2 ml venous blood was taken to detect the levels of progesterone(P) and estriol(E_3) in serum.The therapeutic effects,adverse reactions,serum sex hormones and pregnancy outcomes were compared between two groups.Results After the treatment,the effective rate of observation group was better than that of control group at 48 hours and 7 days(P=0.003,P=0.011).The prolongation time of pregnancy in observation group was longer than that in control group(P=0.016).The total incidence of adverse reactions in observation group was significantly lower than that in control group(6.0% vs 30.0%,χ~2=9.756,P=0.001).After treatment,P levels were higher in two groups(all P<0.05),and P level in observation group was higher than that in control group(P=0.022).The E3 level after treatment was lower in observation group and higher in control group than that before treatment(P<0.05).After treatment,the full-term delivery rate and neonatal survival rate of observation group were higher than those of control group(P=0.000,P=0.012),and the abortion or premature delivery rate was slightly lower than that of the control group,but there was no significant difference(P=0.110).Conclusions Atoxiban can improve the level of serum sex hormone P and reduce the level of E3 to achieve the goal of treating pregnant women with advanced premature delivery.The effect is remarkable,with fewer adverse reactions,high safety and good pregnancy outcomes.
引文
[1] 林初专.观察阿托西班与利托君治疗高龄孕妇先兆早产的效果[J].泰山医学院学报,2017,38(4):440-441.
[2] 曹瑞红,武斌杰,王亮芝.阿托西班与利托君治疗高龄孕妇先兆早产的疗效及对围生儿结局的影响分析[J].中国继续医学教育,2017,9(1):157-158.
[3] 陈静.先兆早产采用宫缩抑制剂治疗的疗效和护理[J].实用妇科内分泌杂志,2016,3(13):102-103.
[4] 戴超艳,刘建.先兆早产的治疗进展[J].科学咨询(科技·管理),2016,5(3):61-62.
[5] Xu YJ,Ran LM,Zhai SS,et al.Evaluation of the efficacy of atosiban in pregnant women with threatened preterm labor associated with assisted reproductive technology[J].Eur Rev Med Pharmacol Sci,2016,20(9):1881-1887.
[6] 杨晓云,吴晓琳.盐酸阿托西班治疗先兆早产的护理[J].江苏医药,2016,42(7):862-863.
[7] 陈静仪,张秀群,钟美雄.醋酸阿托西班治疗先兆早产的临床疗效分析[J].中国现代药物应用,2017,11(17):94-96.
[8] 沈丽,张瑛,陈桂芬.先兆早产孕妇应用宫缩抑制剂治疗对围生儿结局[J].现代仪器与医疗,2016,22(6):131-132.
[9] 秦峰.比较盐酸利托君和阿托班西对35岁以上先兆早产妇女保胎效果、围生儿结局及不良反应发生率的影响[J].中国计划生育和妇产科,2017,9(4):68-71.
[10] 彭向东,丁劲松,周颜彬,等.HPLC-MS-MS测定人血浆中利托君的浓度及其药动学研究[J].中国临床药理学与治疗学,2011,16(3):287-291.
[11] 刘小杰.盐酸利托君联合阿托西班治疗早产的疗效及不良反应观察[J].北方药学,2017,14(7):106-107.
[12] 张东梅,林红.妊娠晚期不典型胎盘早剥误诊为先兆早产24例临床分析[J].广西医学,2012,34(11):1528-1529.
[13] Van Vliet EOG,Nijman TAJ,Schuit E,et al.Nifedipine versus atosiban for threatened preterm birth (APOSTEL Ⅲ):a multicentre,rndomized controlled trial[J].Lancet,2016,387(10033):2117.
[14] 李朝媛,蔡建姝.妊娠4周～9周不同妊娠结局者血清相关激素水平的变化[J].中国卫生检验杂志,2017,27(18):2651.
[2] 曹瑞红,武斌杰,王亮芝.阿托西班与利托君治疗高龄孕妇先兆早产的疗效及对围生儿结局的影响分析[J].中国继续医学教育,2017,9(1):157-158.
[3] 陈静.先兆早产采用宫缩抑制剂治疗的疗效和护理[J].实用妇科内分泌杂志,2016,3(13):102-103.
[4] 戴超艳,刘建.先兆早产的治疗进展[J].科学咨询(科技·管理),2016,5(3):61-62.
[5] Xu YJ,Ran LM,Zhai SS,et al.Evaluation of the efficacy of atosiban in pregnant women with threatened preterm labor associated with assisted reproductive technology[J].Eur Rev Med Pharmacol Sci,2016,20(9):1881-1887.
[6] 杨晓云,吴晓琳.盐酸阿托西班治疗先兆早产的护理[J].江苏医药,2016,42(7):862-863.
[7] 陈静仪,张秀群,钟美雄.醋酸阿托西班治疗先兆早产的临床疗效分析[J].中国现代药物应用,2017,11(17):94-96.
[8] 沈丽,张瑛,陈桂芬.先兆早产孕妇应用宫缩抑制剂治疗对围生儿结局[J].现代仪器与医疗,2016,22(6):131-132.
[9] 秦峰.比较盐酸利托君和阿托班西对35岁以上先兆早产妇女保胎效果、围生儿结局及不良反应发生率的影响[J].中国计划生育和妇产科,2017,9(4):68-71.
[10] 彭向东,丁劲松,周颜彬,等.HPLC-MS-MS测定人血浆中利托君的浓度及其药动学研究[J].中国临床药理学与治疗学,2011,16(3):287-291.
[11] 刘小杰.盐酸利托君联合阿托西班治疗早产的疗效及不良反应观察[J].北方药学,2017,14(7):106-107.
[12] 张东梅,林红.妊娠晚期不典型胎盘早剥误诊为先兆早产24例临床分析[J].广西医学,2012,34(11):1528-1529.
[13] Van Vliet EOG,Nijman TAJ,Schuit E,et al.Nifedipine versus atosiban for threatened preterm birth (APOSTEL Ⅲ):a multicentre,rndomized controlled trial[J].Lancet,2016,387(10033):2117.
[14] 李朝媛,蔡建姝.妊娠4周～9周不同妊娠结局者血清相关激素水平的变化[J].中国卫生检验杂志,2017,27(18):2651.
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