静脉滴注丙种球蛋白防治复发性流产的临床效果
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摘要
目的探讨静脉滴注丙种球蛋白用于复发性流产(RSA)防治的临床效果。方法选取2014年9月～2017年12月在我院进行治疗的90例RSA患者作为观察组,按照患者自主意愿选择静脉滴注丙种球蛋白治疗的46例作为观察1组,选择传统保守治疗的44例作为观察2组,观察比较两组的临床治疗效果及不良反应发生情况。同时选择同期在我院产检的90名健康女性作为对照组,观察比较RSA患者与健康女性的丙种球蛋白水平。结果观察1组的保胎成功率、足月产率均明显高于观察2组(P<0.05),观察1组的早产儿死亡率、流产率均明显低于观察2组(P<0.05);两组的不良反应总发生率比较,差异无统计学意义(P>0.05);观察组γ-干扰素(IFN-γ)、自然杀伤细胞(NK)水平明显低于对照组,观察组白介素-10(IL-10)水平明显高于对照组,差异均有统计学意义(P<0.05)。结论 RSA患者的丙种球蛋白水平与健康女性存在明显差异,可作为预防RSA的有效检测指标。静脉滴注丙种球蛋白治疗RSA可显著提高保胎成功率及足月产率,且安全性高,具有很高的临床应用价值。
Objective To explore the clinical effect of Intravenous Gamma Globulin in the prevention and treatment of recurrent abortion(RSA).Methods A total of 90 patients with RSA who were treated in our hospital from September2014 to December 2017 were selected as observation group,46 patients who were treated with Intravenous Gamma Globulin according to their own willingness were selected as observation group 1,44 patients who chose traditional conservative treatment were selected as observation group 2,and the clinical treatment effects and adverse reactions of the two groups were observed.At the same time,90 healthy women who did pregnancy check-up in the hospital during the same period were selected as the control group.The level of gamma globulin in patients with RSA and healthy women were observed.Results The success rate of pregnancy and full term yield in the observation group 1 were significantly higher than those in the observation group 2(P<0.05).The mortality of premature infant and abortion rate in the observation group 1 were significantly lower than those in the observation group 2(P<0.05),and the total incidence of adverse reactions in the two groups was not significantly different(P>0.05) and the level of gamma interferon(IFN-γ) and natural killer(NK) in the observation group were significantly lower than those in the control group(P<0.05).The level of interleukin-10(IL-10) in the observation group was significantly higher than that in the control group,the differences were statistically significant(P<0.05).Conclusion The level of IFN-γ in RSA patients is significantly different from that in healthy women.It can be used as an effective index to prevent RSA.Intravenous Gamma Globulin in the treatment of RSA can significantly improve the success rate of pregnancy and full term yield,and it has high safety and high clinical value.
Objective To explore the clinical effect of Intravenous Gamma Globulin in the prevention and treatment of recurrent abortion(RSA).Methods A total of 90 patients with RSA who were treated in our hospital from September2014 to December 2017 were selected as observation group,46 patients who were treated with Intravenous Gamma Globulin according to their own willingness were selected as observation group 1,44 patients who chose traditional conservative treatment were selected as observation group 2,and the clinical treatment effects and adverse reactions of the two groups were observed.At the same time,90 healthy women who did pregnancy check-up in the hospital during the same period were selected as the control group.The level of gamma globulin in patients with RSA and healthy women were observed.Results The success rate of pregnancy and full term yield in the observation group 1 were significantly higher than those in the observation group 2(P<0.05).The mortality of premature infant and abortion rate in the observation group 1 were significantly lower than those in the observation group 2(P<0.05),and the total incidence of adverse reactions in the two groups was not significantly different(P>0.05) and the level of gamma interferon(IFN-γ) and natural killer(NK) in the observation group were significantly lower than those in the control group(P<0.05).The level of interleukin-10(IL-10) in the observation group was significantly higher than that in the control group,the differences were statistically significant(P<0.05).Conclusion The level of IFN-γ in RSA patients is significantly different from that in healthy women.It can be used as an effective index to prevent RSA.Intravenous Gamma Globulin in the treatment of RSA can significantly improve the success rate of pregnancy and full term yield,and it has high safety and high clinical value.
引文
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[9]高燕,王萍玲,张志军.不明原因复发性流产母胎界面蜕膜组织NK细胞及T淋巴细胞亚群的变化[J].武汉大学学报(医学版),2018,39(1):128-131.
[10]闫萍,徐文,付红萍,等.静脉注射丙种球蛋白预防早产儿深静脉置管时真菌感染的价值分析[J].中华医院感染学杂志,2018,28(10):1559-1562.
[11]肖金生,王厚照.8项凝血相关指标与复发性流产的相关性研究[J].国际医药卫生导报,2018,24(7):1092-1094.
[12]赵庶君.探讨抗磷脂综合征导致复发性流产患者的免疫治疗效果[J].中国现代药物应用,2018,12(2):190-191.
[13]郭义红,李晓彬,陈亮,等.小剂量低分子肝素联合免疫球蛋白治疗难治性先兆流产合并绒毛膜下血肿效果评价[J].临床和实验医学杂志,2017,16(16):1623-1627.
[14]罗智华,姚吉龙.复发性流产患者主动免疫治疗前后种植窗外周血及子宫内膜淋巴细胞亚群变化[J].东南大学学报(医学版),2018,37(1):91-96.
[15]刘晓丽,邓飞越,周杨,等.免疫球蛋白降低对复发性流产患者NK细胞的疗效评价[J].中国妇幼健康研究,2018,29(1):92-95.
[2]孙莉,梁磊,杨波.主动联合被动免疫疗法治疗封闭抗体阴性孕妇复发性流产临床观察[J].山东医药,2015,58(43):44-45.
[3]石瑛,王云凤,任静静,等.淋巴细胞主动免疫联合丙种球蛋白治疗复发性流产的Meta分析[J].中国妇幼保健,2018,33(6):1429-1434.
[4]赵宁,乔宠.复发性流产患者生化妊娠病因的多因素分析[J].现代妇产科进展,2018,27(2):134-136.
[5]孙佳宁,张杨,陈璐,等.补肾健脾类中药治疗原因不明复发性流产研究进展[J].吉林中医药,2018,38(4):490-493.
[6]岑振考,杨华丽.脂肪乳与丙种球蛋白对因自然杀伤细胞活性升高所致复发性流产患者妊娠结局的影响[J].实用临床医学,2018,19(2):53-55.
[7]高颖,郑娇妮.主动免疫治疗复发性流产的临床观察[J].中国妇幼保健,2018,33(5):1127-1128.
[8]吕春红,王连珠.丙种球蛋白联合淋巴细胞主动免疫治疗复发性流产的疗效[J].实用临床医药杂志,2016,20(7):96-98.
[9]高燕,王萍玲,张志军.不明原因复发性流产母胎界面蜕膜组织NK细胞及T淋巴细胞亚群的变化[J].武汉大学学报(医学版),2018,39(1):128-131.
[10]闫萍,徐文,付红萍,等.静脉注射丙种球蛋白预防早产儿深静脉置管时真菌感染的价值分析[J].中华医院感染学杂志,2018,28(10):1559-1562.
[11]肖金生,王厚照.8项凝血相关指标与复发性流产的相关性研究[J].国际医药卫生导报,2018,24(7):1092-1094.
[12]赵庶君.探讨抗磷脂综合征导致复发性流产患者的免疫治疗效果[J].中国现代药物应用,2018,12(2):190-191.
[13]郭义红,李晓彬,陈亮,等.小剂量低分子肝素联合免疫球蛋白治疗难治性先兆流产合并绒毛膜下血肿效果评价[J].临床和实验医学杂志,2017,16(16):1623-1627.
[14]罗智华,姚吉龙.复发性流产患者主动免疫治疗前后种植窗外周血及子宫内膜淋巴细胞亚群变化[J].东南大学学报(医学版),2018,37(1):91-96.
[15]刘晓丽,邓飞越,周杨,等.免疫球蛋白降低对复发性流产患者NK细胞的疗效评价[J].中国妇幼健康研究,2018,29(1):92-95.