低分子肝素联合小剂量阿司匹林治疗自身免疫型复发性流产的疗效观察(1)
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【摘要】 目的 探讨自身免疫因素所致复发性流产的治疗方法及疗效。方法 54例患者随机分为两组。确诊抗心磷脂抗体阳性的治疗组(27例)，妊娠前就开始服用阿司匹林25 mg/d,，经确诊“宫内妊娠”后每日低分子肝素5000 IU,皮下注射，1次/d。对照组(27例)妊娠前同样给予阿司匹林25 mg/d， 确诊宫内妊娠后给以黄体酮治疗,20 mg/d肌注,或绒毛膜促性腺激素1000IU，每日肌注一次。7~14 d，口服维生素E胶丸100 mg，3次/d，观察临床有效率，对结果进行统计学分析。结果 治疗组总有效率为94.3%，对照组74.1%，差异有统计学意义(P<0.05)。结论 低分子肝素联合小剂量阿司匹林治疗自身免疫型复发性流产取得满意的效果，提高了妊娠成功率，值得临床进一步推广。
【关键词】 自身免疫型;复发性流产; 治疗;低分子肝素;阿司匹林
Low molecular weight heparin combined with low-dose aspirin therapy for autoimmune-recurrent spontaneous abortion
ZHANG Yong-hong,LIU Qiao-ying.
Women and Children healthcare hospital in Boluo county, Huizhou city, Guangdong province 516100,China
【Abstract】 Objective To discuss the treatment and efficacy of recurrent spontaneous abortion,(RSA)which was caused by autoimmune factors. Methods 54 patients wererandomly divided into two groups.Diagnosed with anticardiolipin antibodies(Anticardiolipin Antibodies, ACA)-positive group(27 cases), beginning before pregnancy, aspirin 25 mg/d; once diagnosed “intrauterine pregnancy”, then low molecular weight heparin 5000 IU, subcutaneous injection once a day.The control group(27cases)took the same treatment were given aspirin before pregnancy 25 mg/g;after the diagnosis of intrauterine pregnancy,then were given progesterone 20 mg daily with intramuscular injection, or HCG 1000 IU daily, intramuscular injection 7 to 14 days, two groups were took orally vitamin E capsules 100 mg, 3 times/day. Then observe the clinical efficacy. The results were analyzed statistically.Results The effective rate was 94.3% in treated group, 74.1% in control group, the difference was significant statistically(P<0.05). Conclusion Low molecular weight heparin and low-dose aspirin therapy for autoimmune-recurrent spontaneous abortion achieved satisfactory results and improve the success rate of pregnancy, is worthy of further promotion.
【Key words】 Autoimmune； Recurrent abortion; Low molecular weight heparin; Aspirin
复发性流产(,RSA)是指连续发生2次或2次以上的流产，约1/3的病例与自身免疫过强或血栓前状态有关[1]，近几年研究发现，抗心磷脂抗体(ACA)所致流产在RSA中占20%左右[2]，抗心磷脂抗体阳性易致胎盘绒毛微血管栓塞 ......
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