地屈孕酮片与主动免疫联用治疗不明原因复发性流产的临床分析
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摘要
目的探讨丈夫或第三方外周血淋巴细胞注射主动免疫联合口服地屈孕酮片治疗不明原因复发性流产的临床疗效。方法 200例封闭抗体均为阴性的复发性流产患者,随机分为观察组和对照组,各100例。对照组为孕后开始接受淋巴细胞注射联合口服地屈孕酮片治疗,观察组孕前开始接受淋巴细胞注射、妊娠后加服地屈孕酮片治疗,对比两组疗效。结果孕9~12周后,观察组雌二醇(E2)、孕激素(P)、绒毛膜促性腺激素(HCG)指标优于对照组,差异具有统计学意义(P<0.05);观察组流产率、保胎成功率和新生儿畸形率分别为2%、98%、0,优于对照组的24%、66%、10%,两组比较差异具有统计学意义(P<0.05)。结论地屈孕酮片与主动免疫联用治疗不明原因复发性流产具有较高的安全性,治疗效果好,可以提升胎儿的存活率,降低流产率。
Objective To explore the clinical effect of husband or third party peripheral blood lymphocyte injection active immunity combined with oral dydrogesterone in the treatment of unexplained recurrent spontaneous abortion. Methods A total of 200 recurrent spontaneous abortion patients with negative closed antibodies were randomly divided into observation group and control group, with 100 cases in each group. The control group received lymphocyte injection combined oral dydrogesterone tablets for treatment after pregnant, and the observation group received lymphocyte injection before pregnant and dydrogesterone tablets for treatment after pregnant. Curative effect was compared in two groups. Results After 9~12 weeks of pregnant, the observation group had better estradiol(E2), progesterone(P) and human chorionic gonadotropin(HCG) than the control group, and the difference had statistical significance(P<0.05). The observation group had abortion rate, success rate of spuc and neonatal malformation rate respectively as 2%, 98% and 0, which were all better than 24%, 66% and 10% in the control group, and the difference had statistical significance(P<0.05). Conclusion Combination of dydrogesterone tablets and active immunity shows high security for the treatment of unexplained recurrent spontaneous abortion, and it also can increase fetal survival rate and reduce abortion rate.
Objective To explore the clinical effect of husband or third party peripheral blood lymphocyte injection active immunity combined with oral dydrogesterone in the treatment of unexplained recurrent spontaneous abortion. Methods A total of 200 recurrent spontaneous abortion patients with negative closed antibodies were randomly divided into observation group and control group, with 100 cases in each group. The control group received lymphocyte injection combined oral dydrogesterone tablets for treatment after pregnant, and the observation group received lymphocyte injection before pregnant and dydrogesterone tablets for treatment after pregnant. Curative effect was compared in two groups. Results After 9~12 weeks of pregnant, the observation group had better estradiol(E2), progesterone(P) and human chorionic gonadotropin(HCG) than the control group, and the difference had statistical significance(P<0.05). The observation group had abortion rate, success rate of spuc and neonatal malformation rate respectively as 2%, 98% and 0, which were all better than 24%, 66% and 10% in the control group, and the difference had statistical significance(P<0.05). Conclusion Combination of dydrogesterone tablets and active immunity shows high security for the treatment of unexplained recurrent spontaneous abortion, and it also can increase fetal survival rate and reduce abortion rate.
引文
[1]杨静,王妍,郭冬梅,等.免疫因素所致复发性流产的研究进展.中华医学杂志,2014,94(27):2159-2160.
[2]赵静,巩晓芸,胡泊,等.淋巴细胞主动免疫治疗不明原因复发性流产91例临床研究.新疆医科大学学报,2011,34(1):77-80.
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[4]龙琦琦,张绍芬,韩懿,等.促性腺激素释放激素激动剂联合戊酸雌二醇及地屈孕酮治疗子宫内膜异位症的临床疗效与安全性.中华妇产科杂志,2010,45(4):247-251.
[5]郭静,吴效科,胡振兴.脂肪乳联合地屈孕酮治疗主动免疫治疗不敏感封闭抗体阴性复发性流产患者的效果观察.吉林医学,2016,37(9):2151-2153.
[6]杨倩.地屈孕酮辅助主动免疫疗法治疗复发性流产的疗效观察.药物流行病学杂志,2016(2):83-86.
[7]张娟,方小玲,贺艳坤,等.主动免疫治疗加用地屈孕酮治疗复发性流产的临床观察.实用预防医学,2012,19(7):1048-1050.
[8]张峰,张国英,徐秀华,等.主动免疫联合地屈孕酮治疗复发性流产的临床疗效研究.生殖医学杂志,2014,23(4):320-323.
[9]苏迎春,肖素梅,甘建宁,等.3种不同免疫治疗方法治疗不明原因复发性自然流产的效果比较.中国妇幼保健,2016,31(6):1228-1230.
[10]梁宝珠,谭忠伟,黎彩鹏,等.淋巴细胞主动免疫治疗复发性流产的临床研究.中国妇幼保健,2007,22(25):3561-3562.
[11]刘素芳,冀雪霞,王永明,等.主动免疫联合地屈孕酮治疗不明原因复发性流产临床分析.河北医药,2010,32(16):2233-2234.
[12]刘庆丽,李娜,冯晓玲.复发性流产患者子宫内膜容受性相关影响因素的研究进展.生殖与避孕,2016,18(10):839-844.
[13]陈延斌,吕祺.主动免疫联合地屈孕酮片对不明原因复发性流产的疗效.中国妇幼保健,2015,30(35):6291-6293.
[14]柳月霞.主动免疫联合地屈孕酮治疗复发性流产的临床效果.中国现代药物应用,2015,9(5):163-164.
[2]赵静,巩晓芸,胡泊,等.淋巴细胞主动免疫治疗不明原因复发性流产91例临床研究.新疆医科大学学报,2011,34(1):77-80.
[3]叶恒君,钟春华,周玉玲,等.不明原因复发性流产孕早期免疫治疗疗效观察.当代医学,2010,16(4):1-2.
[4]龙琦琦,张绍芬,韩懿,等.促性腺激素释放激素激动剂联合戊酸雌二醇及地屈孕酮治疗子宫内膜异位症的临床疗效与安全性.中华妇产科杂志,2010,45(4):247-251.
[5]郭静,吴效科,胡振兴.脂肪乳联合地屈孕酮治疗主动免疫治疗不敏感封闭抗体阴性复发性流产患者的效果观察.吉林医学,2016,37(9):2151-2153.
[6]杨倩.地屈孕酮辅助主动免疫疗法治疗复发性流产的疗效观察.药物流行病学杂志,2016(2):83-86.
[7]张娟,方小玲,贺艳坤,等.主动免疫治疗加用地屈孕酮治疗复发性流产的临床观察.实用预防医学,2012,19(7):1048-1050.
[8]张峰,张国英,徐秀华,等.主动免疫联合地屈孕酮治疗复发性流产的临床疗效研究.生殖医学杂志,2014,23(4):320-323.
[9]苏迎春,肖素梅,甘建宁,等.3种不同免疫治疗方法治疗不明原因复发性自然流产的效果比较.中国妇幼保健,2016,31(6):1228-1230.
[10]梁宝珠,谭忠伟,黎彩鹏,等.淋巴细胞主动免疫治疗复发性流产的临床研究.中国妇幼保健,2007,22(25):3561-3562.
[11]刘素芳,冀雪霞,王永明,等.主动免疫联合地屈孕酮治疗不明原因复发性流产临床分析.河北医药,2010,32(16):2233-2234.
[12]刘庆丽,李娜,冯晓玲.复发性流产患者子宫内膜容受性相关影响因素的研究进展.生殖与避孕,2016,18(10):839-844.
[13]陈延斌,吕祺.主动免疫联合地屈孕酮片对不明原因复发性流产的疗效.中国妇幼保健,2015,30(35):6291-6293.
[14]柳月霞.主动免疫联合地屈孕酮治疗复发性流产的临床效果.中国现代药物应用,2015,9(5):163-164.