首页|地屈孕酮联合硝苯地平对先兆流产患者妊娠结局与血清miRNA-141、miRNA-518e的影响

地屈孕酮联合硝苯地平对先兆流产患者妊娠结局与血清miRNA-141、miRNA-518e的影响

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目的 探讨地屈孕酮结合硝苯地平对先兆流产患者妊娠结局及血清miRNA-141、miRNA-518e的影响.方法 采用横断面研究,选取陕西省结核病防治院2020年5月至2023年5月收治的117例先兆流产患者开展试验,以电脑编号奇偶数字分为结合组(58例)及参考组(59例).参考组予以硝苯地平治疗(10 mg/次,3次/d;持续给药3 d后,调整剂量为20 mg/次,3次/d,持续给药直至症状完全消失为止),结合组则于参考组基础上加用地屈孕酮治疗(首次给药剂量40 mg,之后间隔12 h给药1次,调整剂量10 mg/次,持续给药至症状彻底消失).比较两组妊娠结局、生殖激素水平、子宫动脉血流参数、血清miRNA-141与miRNA-518e水平.采用t检验、x2检验进行统计比较.结果 结合组流产率低于参考组,足月妊娠率高于参考组[3.45%(2/58)比15.25%(9/59)、86.21%(50/58)比64.41%(38/59)],两组比较差异均有统计学意义(均P<0.05).治疗30 d后两组各项生殖激素水平均高于治疗前1 d,且结合组升高幅度优于参考组,两组比较差异均有统计学意义(均P<0.05);两组各项子宫动脉血流参数均低于治疗前1 d,且结合组下调幅度优于参考组,两组比较差异均有统计学意义(均P<0.05);两组血清miRNA-141、miRNA-518e水平均低于治疗前1 d,且结合组低于参考组[(20.73±1.82)比(24.81±2.09)、(15.97±1.45)比(22.50±2.03)],两组比较差异均有统计学意义(均 P<0.05).结论 地屈孕酮结合硝苯地平能显著改善先兆流产患者妊娠结局、生殖激素及子宫动脉血流,同时可负向调控miRNA-141、miRNA-518e的表达.
Effects of dydrogesterone combined with nifedipine on pregnancy outcomes and serum miRNA-141 and miRNA-518e in patients with threatened abortion
Objective To study the effects of dydrogesterone combined with nifedipine on the improvement of pregnancy outcomes and serum miRNA-141 and miRNA-518e in patients with threatened abortion.Methods One hundred and seventeen patients with threatened abortion admitted to Shaanxi Provincial Tuberculosis Prevention and Control Hospital from May 2020 to May 2023 were selected,and were divided into a combination group(58 cases)and a reference group(59 cases)by the computer random odd-even number method.The reference group was treated with nifedipine 10 mg/time,3 times/day,for 3 days,and the dosage was adjusted to 20 mg/time,3 times/day;they took the medicine until their symptoms completely disappeared.The combination group were treated with dydrogesterone on the basis of the reference group;the first dose was 40 mg,then the dosage was 10 mg/time every other 12 h;they took the medicine until their symptoms completely disappeared.The pregnancy outcomes,reproductive hormone levels,uterine artery blood flow parameters,and serum levels of miRNA-141 and miRNA-518e were compared between the two groups.t and x2 tests were applied.Results The abortion rate of the combination group was lower than that of the reference group,but the full-term pregnancy rate was higher than that ofthe reference group[3.45%(2/58)vs.15.25%(9/59)and 86.21%(50/58)vs.64.41%(38/59)],with statistical differences between the two groups(both P<0.05).After 30 days'treatment,the levels of reproductive hormones in both groups were significantly higher than those 1 day before the treatment,and the increases in combination group were better than those in the reference group(all P<0.05).After 30 days'treatment,all the uterine artery blood flow parameters in both groups were lower than those 1 day before the treatment,and the down-regulation amplitudes in combination group were better than those in the reference group(all P<0.05).After 30 days'treatment,the serum levels of miRNA-141 and miRNA-518e in both groups were lower than those 1 day before the treatment,and the levels in combination group were lower than those in the reference group[(20.73±1.82)vs.(24.81±2.09)and(15.97±1.45)vs.(22.50±2.03)],with statistical differences between the two groups(both P<0.05).Conclusion Dydrogesterone combined with nifedipine for patients with threatened abortion can improve their pregnancy outcomes,reproductive hormones,and uterine artery blood flow,and negatively regulate the expression of miRNA-141 and miRNA-518e.

Threatened abortionDydrogestoneNifedipinePregnancy outcomesMiRNA-141MiRNA-518e

孙秀利、缑良芝、郭倩、高亚娟、高瑜、王运萍、李亚波

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陕西省结核病防治院陕西省第五人民医院妇产科,西安 710100

空军军医大学第一附属医院妇产科,西安 710032

先兆流产 地屈孕酮 硝苯地平 妊娠结局 miRNA-141 miRNA-518e

国家自然科学基金西安市科技厅计划

8117245822YXYJ0160

2024

国际医药卫生导报
中华医学会,国际医药卫生导报社

国际医药卫生导报

影响因子:0.781
ISSN:1007-1245
年,卷(期):2024.30(15)
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