世界临床药物2024,Vol.45Issue(12) :1292-1299.DOI:10.13683/j.wph.2024.12.013

粒细胞集落刺激因子联合低分子肝素对反复种植失败患者的疗效分析

Efficacy analysis of granulocyte colony-stimulating factor combined with low molecular weight heparin in patients with repeated implantation failure

乔天琪 崔艺舰 罗怡宁 高艳霞 赵海君 卢静
世界临床药物2024,Vol.45Issue(12) :1292-1299.DOI:10.13683/j.wph.2024.12.013

粒细胞集落刺激因子联合低分子肝素对反复种植失败患者的疗效分析

Efficacy analysis of granulocyte colony-stimulating factor combined with low molecular weight heparin in patients with repeated implantation failure

乔天琪 1崔艺舰 2罗怡宁 3高艳霞 4赵海君 5卢静5
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作者信息

  • 1. 邯郸市中心医院生殖医学科,河北邯郸 056000;河北北方学院研究生学院,河北 张家口 075000
  • 2. 邯郸市中心医院输血科,河北邯郸 056000
  • 3. 重庆医科大学公共卫生学院,重庆 401331
  • 4. 邯郸市妇幼保健院检验科,河北邯郸 056000
  • 5. 邯郸市中心医院生殖医学科,河北邯郸 056000
  • 折叠

摘要

目的 探讨粒细胞集落刺激因子(granulocyte colony-stimulating factor,G-CSF)联合低分子肝素(low molecular weight heparin,LMWH)皮下注射对体外受精/卵胞质内单精子注射(in vitro fertilization/intracytoplasmic sperm injection,IVF/ICSI)周期不明原因反复种植失败(unexplained repeated implantation failure,URIF)患者冻融胚胎移植(frozen-thawed embryo transfer,FET)临床妊娠结局的影响.方法 分析2017年1月至2023年3月在邯郸市中心医院生殖医学科行IVF/ICSI的URIF患者资料,根据治疗方式分组,FET周期接受G-CSF联合LMWH皮下注射者设为A组,接受G-CSF皮下注射者设为B组;接受LMWH皮下注射者设为C组;仅接受常规黄体支持治疗者设为D组.据患者基本资料行倾向性评分匹配,设定卡钳值0.02.比较本次FET周期特征、临床妊娠结局、产科结局、新生儿结局及重大不良反应情况.结果 本次FET周期各组患者特征差异均无统计学意义(P>0.05);各组胚胎种植率、临床妊娠率以及β-人绒毛膜促性腺激素(human chorionic gonadotropin,HCG)阳性率差异有统计学意义(P=0.002,P=0.006,P=0.007).各组足月产率、早产率、双胎率、产科并发症率(妊高症率、胎膜早破率)以及新生儿并发症率(巨大儿率、低体质量儿率)比较,差异均无统计学意义(P>0.05).结论 G-CSF联合LMWH皮下注射可提高URIF患者FET周期的胚胎种植率、临床妊娠率以及β-HCG阳性率,是URIF的一种有效治疗手段.

Abstract

Objective To investigate the effects of subcutaneous injection of granulocyte colony-stimulating factor(G-CSF)combined with low molecular weight heparin(LMWH)on the clinical pregnancy outcome of freeze-thaw embryo transfer(FET)in patients with unexplained repeated implantation failure(URIF)during in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)cycles.Methods The data of URIF patients who underwent IVF/ICSI in the department of reproductive medicine of Handan central hospital from January 2017 to March 2023 were analyzed,according to the treatment methods,group A received subcutaneous injection of G-CSF combined with LMWH during FET cycle,group B received subcutaneous injection of G-CSF,group C received subcutaneous injection of LMWH,group D received conventional luteal support therapy.According to the patients'basic data,the propensity score matching was performed,and the caliper value was set to 0.02.The FET cycle characteristics,clinical pregnancy outcome,obstetric outcome and neonatal outcome and major adverse reactions were compared.Results There was no statistical significance in the characteristics of patients in each group during the FET cycle(P>0.05).There were significant differences in embryo implantation rate,clinical pregnancy rate and β-human chorionic gonadotropin(HCG)positive rate among all groups(P=0.002,P=0.006,P=0.007).There were no significant differences in term birth rate,preterm birth rate,twin rate,obstetric complications rate(pregnation-induced hypertension rate,premature rupture rate)and neonatal complications rate(macrosomia rate,low birth weight rate)among all groups(P>0.05).Conclusion G-CSF combined LMWH subcutaneously can improve the embryos grow rate,clinical pregnancy rate and β-HCG positive rate of FET cycle in URIF patients,which is an effective treatment.

关键词

粒细胞集落刺激因子/低分子肝素/不明原因反复种植失败/胚胎种植率/临床妊娠率

Key words

granulocyte colony-stimulating factor/low molecular weight heparin/unexplained repeated implantation failure/embryo implantation rate/clinical pregnancy rate

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出版年

2024
世界临床药物
上海医药工业研究院

世界临床药物

CSTPCD
影响因子:0.849
ISSN:1672-9188
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