溴隐亭应用于妊娠合并高泌乳素血症患者对其妊娠结局的影响
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摘要
目的探讨溴隐亭对妊娠合并高泌乳素血症患者的妊娠结局的影响。方法回顾性分析2015年1月-2017年6月收治的84例患有高泌乳素血症的妊娠患者的诊疗情况。按照患者孕早期是否服用溴隐亭,将研究对象分为对照组(44例)和观察组(40例)。随访观察2组患者至妊娠结束,比较2组患者的流产发生率、流产发生后的保胎成功率和妊娠结局。结果观察组患者总流产发生率(15.00%)明显低于对照组(43.18%),2组比较差异有统计学意义(P<0.05)。观察组先兆流产患者的保胎成功率(92.86%)明显高于对照组(61.54%),2组比较差异有统计学意义(P<0.05)。观察组保胎成功至足月阴道分娩率(41.18%)明显高于对照组(16.00%),2组比较差异有统计学意义(P<0.05);2组早产儿、低体质量儿、新生儿窒息的发生率差异无统计学意义(P>0.05)。结论溴隐亭孕期应用能明显改善妊娠合并高泌乳素血症患者的妊娠结局,降低流产发生率,提高保胎成功率,建议在临床推广应用。
Objective To investigate the effect of bromocriptine on pregnancy outcome in pregnant women with hyperprolactinemia.Methods The clinical data of 84 pregnant women with hyperprolactinemia from January 2015 to June 2017 were retrospectively analyzed.Patients were divided into control group(44 cases)and observation group(40 cases)according to whether they took bromocriptine in the first trimester of pregnancy.Two groups of patients were followed up to the end of pregnancy.The incidence of abortion,the success rate of fetus after abortion,the outcome of pregnancy and the level of serum hormone in the two groups were compared.Results The incidence of total abortion in the observation group(15.00%)was significantly lower than that in the control group(43.18%),and the difference between the two groups was statistically significant(P <0.05).The success rate of fetal abortion in the observation group(92.86%)was significantly higher than that in the control group(61.54%),and the difference between the two groups was statistically significant(P <0.05).The success rate of fetal vaginal delivery(41.18%)in the observation group was significantly higher than that of the control group(16.00%),and the difference between the 2 groups was statistically significant(P <0.05).There was no significant difference in the incidence of premature infants,low birth weight infants and neonatal asphyxia between the 2 groups(P >0.05).Conclusion The application of bromocriptine during pregnancy can obviously improve the pregnancy outcome of pregnancy with hyperprolactinemia,reduce the incidence of abortion,improve the rate of fetal success,and do not increase the risk of pregnancy and newborn.It is suggested to be widely used in clinical practice.
Objective To investigate the effect of bromocriptine on pregnancy outcome in pregnant women with hyperprolactinemia.Methods The clinical data of 84 pregnant women with hyperprolactinemia from January 2015 to June 2017 were retrospectively analyzed.Patients were divided into control group(44 cases)and observation group(40 cases)according to whether they took bromocriptine in the first trimester of pregnancy.Two groups of patients were followed up to the end of pregnancy.The incidence of abortion,the success rate of fetus after abortion,the outcome of pregnancy and the level of serum hormone in the two groups were compared.Results The incidence of total abortion in the observation group(15.00%)was significantly lower than that in the control group(43.18%),and the difference between the two groups was statistically significant(P <0.05).The success rate of fetal abortion in the observation group(92.86%)was significantly higher than that in the control group(61.54%),and the difference between the two groups was statistically significant(P <0.05).The success rate of fetal vaginal delivery(41.18%)in the observation group was significantly higher than that of the control group(16.00%),and the difference between the 2 groups was statistically significant(P <0.05).There was no significant difference in the incidence of premature infants,low birth weight infants and neonatal asphyxia between the 2 groups(P >0.05).Conclusion The application of bromocriptine during pregnancy can obviously improve the pregnancy outcome of pregnancy with hyperprolactinemia,reduce the incidence of abortion,improve the rate of fetal success,and do not increase the risk of pregnancy and newborn.It is suggested to be widely used in clinical practice.
引文
[1]李建薇,张倩莹.内科内分泌疾病与复发性流产[J].实用妇产科杂志,2016,32(2):89-92.
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[7]王慧玉,陈丽红.溴隐亭不同给药时机对高泌乳素血症妇女促性腺激素诱导排卵的影响[J].中国临床药理学杂志,2015,31(1):3-4,10.
[8]黄燕冰,黄利娟,邓跃飞,等.甲磺酸溴隐亭治疗垂体催乳素大腺瘤合并不孕症的临床观察[J].中国妇产科临床杂志,2015,16(4):305-308.
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[10]梁微微,李乃适,赵维纲.溴隐亭治疗2型糖尿病的研究进展[J].重庆医科大学学报,2015,40(7):1011-1015.
[11]ELSERSY MAM.Efficacy of combined cabergoline and metformin compared to metformin alone on cycle regularity in patients with polycystic ovarian disease with hyperprolactinemia:a randomized clinical trial[J].J Obstet Gynaecol India,2017,67(5):363-369.
[12]付云宝,周培校,付蔷,等.溴隐亭与生殖激素配合诱导产后泌乳羊发情的效果试验[J].中国兽医杂志,2015,51(9):37-39,42.
[13]施静,杨帆.溴隐亭在促排卵治疗中的应用[J].中国新药与临床杂志,2014,33(3):164-167.
[14]李娟,柳汝明,郑巧玲,等.溴隐亭治疗2型糖尿病有效性及安全性的Meta分析[J].中国糖尿病杂志,2016,24(11):990-995.
[15]王雯,姚伟峰.不同剂量溴隐亭对催乳素瘤临床疗效、血清催乳素水平及肿瘤体积的影响[J].中国药房,2017,28(26):3681-3684.
[2]谢幸,苟文丽.妇产科学[M].8版.北京:人民卫生出版社,2013.
[3]TAKECHI K,YOSHIOKA Y,KAWAZOE H.Psychiatric patients with antipsychotic drug-induced hyperprolactinemia and menstruation disorders[J].Biol Pharm Bull,2017,40(10):1775-1778.
[4]罗雪珍,林金芳.高泌乳素血症对女性的不良影响[J].实用妇产科杂志,2016,32(7):483-484.
[5]田倩玉,杨欣.无妊娠要求的高泌乳素血症治疗策略及监测[J].实用妇产科杂志,2016,32(7):487-489.
[6]黄禾,田秦杰.高泌乳素血症妊娠相关治疗策略[J].实用妇产科杂志,2016,32(7):485-487.
[7]王慧玉,陈丽红.溴隐亭不同给药时机对高泌乳素血症妇女促性腺激素诱导排卵的影响[J].中国临床药理学杂志,2015,31(1):3-4,10.
[8]黄燕冰,黄利娟,邓跃飞,等.甲磺酸溴隐亭治疗垂体催乳素大腺瘤合并不孕症的临床观察[J].中国妇产科临床杂志,2015,16(4):305-308.
[9]GRIGG J,WORSLEY R,THEW C.Antipsychotic-induced hyperprolactinemia:synthesis of world-wide guidelines and integrated recommendations for assessment,management and future research[J].Psychopharmacology,2017,234(22):3279-3297.
[10]梁微微,李乃适,赵维纲.溴隐亭治疗2型糖尿病的研究进展[J].重庆医科大学学报,2015,40(7):1011-1015.
[11]ELSERSY MAM.Efficacy of combined cabergoline and metformin compared to metformin alone on cycle regularity in patients with polycystic ovarian disease with hyperprolactinemia:a randomized clinical trial[J].J Obstet Gynaecol India,2017,67(5):363-369.
[12]付云宝,周培校,付蔷,等.溴隐亭与生殖激素配合诱导产后泌乳羊发情的效果试验[J].中国兽医杂志,2015,51(9):37-39,42.
[13]施静,杨帆.溴隐亭在促排卵治疗中的应用[J].中国新药与临床杂志,2014,33(3):164-167.
[14]李娟,柳汝明,郑巧玲,等.溴隐亭治疗2型糖尿病有效性及安全性的Meta分析[J].中国糖尿病杂志,2016,24(11):990-995.
[15]王雯,姚伟峰.不同剂量溴隐亭对催乳素瘤临床疗效、血清催乳素水平及肿瘤体积的影响[J].中国药房,2017,28(26):3681-3684.