首页|不同治疗方法对复发性流产患者血清同型半胱氨酸水平的影响及临床意义

不同治疗方法对复发性流产患者血清同型半胱氨酸水平的影响及临床意义

Effect and clinical significance of different treatment approaches on serum homocysteine level in patients with recurrent spontaneous abortion

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目的 探讨肌肉注射维生素B12及口服复合维生素治疗血清同型半胱氨酸(HCY)升高的复发性流产(RSA)患者的疗效.方法 选取HCY升高的RSA患者137例作为研究对象,分为注射组(肌肉注射维生素B12)和口服组(口服爱乐维复合维生素片),收集2组患者的年龄、自然流产次数、抗核抗体谱(ANA)、血清D-二聚体水平等一般资料,比较2组患者治疗前后HCY水平、治疗后HCY正常的百分率、HCY降至正常的时间、低分子肝素使用率、妊娠率、保胎成功率、抱婴率及妊娠合并症.结果 与口服组比较,治疗后注射组患者HCY水平明显降低(P=0.002),HCY正常的百分率明显升高(P=0.042),HCY降至正常的时间明显缩短(P<0.001),妊娠率及抱婴率均明显升高(P<0.05),妊娠合并症的发生率明显降低(P=0.003).结论 与口服复合维生素治疗比较,肌肉注射维生素B12治疗HCY升高的RSA患者,能在较短时间内有效降低血清HCY水平,更能够改善患者的临床结局及减少妊娠合并症.
Objective To investigate the therapeutic efficacy of intramuscular injection of vitamin B12 and oral multivitamins in treating patients with recurrent spontaneous abortion(RSA)complicated with elevated serum homocysteine(HCY).Methods A total of 137 RSA patients with elevated HCY were selected as research subjects,and divided into injection group(intramuscular injection of vitamin B12)and oral group(oral Aleve multivitamin tablets).General data of two groups were collected,including age,the number of spontaneous abortion,serum D-dimer level.HCY level before and after treatment,the percentage of normal HCY after treatment,the time of HCY falling to normal,the use rate of low molecular weight heparin,pregnancy rate,the success rate of fetal pregnancy,the rate of holding baby and pregnancy complications were compared between two groups.Results When compared with oral group,injection group had significantly decreased HCY level(P=0.002),the increased percentage of normal HCY(P=0.042),the shortened time of HCY falling to normal(P<0.001),the increased pregnancy rate and the increased rate of holding baby(P<0.05)as well as the decreased incidence of pregnancy complications(P=0.003).Conclusion When compared with the oral multivitamins,intramuscular injection of vitamin B12 in treating RSA patients with elevated HCY can effectively reduce the serum HCY level in a short time,and improve the clinical outcomes of the patients and reduce pregnancy complications.

recurrent spontaneous abortionvitamin B12homocysteineoral administrationintramuscular injectionpregnancy outcome

陈誉尹、赵淑云、田维婷、梁耀允、李伟霞、钟兴明、黄官友

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贵州医科大学附属医院生殖中心,贵州贵阳 550004

毕节市中医院妇产科,贵州毕节 551700

广东省计划生育科学技术研究所生殖中心,广东广州 510600

复发性流产 维生素B12 同型半胱氨酸 口服 肌肉注射 妊娠结局

贵州省科技计划项目

黔科合支撑[2019]2809号

2024

贵州医科大学学报
贵阳医学院

贵州医科大学学报

CSTPCD
影响因子:0.827
ISSN:2096-8388
年,卷(期):2024.49(4)
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