摘要
目的 分析静脉注射免疫球蛋白(IVIG)治疗习惯性流产(RSA)并绒毛膜下血肿(SCH)的效果及对母婴结局的影响.方法 选择2020 年3 月—2021 年3 月接诊的101 例RSA并SCH,按治疗方法不同分为IVIG组53 例(予IVIG)和对照组48 例(予常规对症治疗),分析治疗前后免疫学指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)、B淋巴细胞、自然杀伤(NK)细胞、甲状腺过氧化物酶抗体、补体C3、补体C4、免疫球蛋白A(IgA)、IgG、IgM]、症状改善指标、不良反应及母婴结局.结果 与治疗前比较,2 组B淋巴细胞、NK细胞、甲状腺过氧化物酶抗体、IgA、IgG、IgM、TNF-α水平明显降低,补体C3、C4 及IL-10 水平明显升高,且IVIG组变化更明显(P＜0.05,P＜0.01).IVIG组阴道出血持续时间、症状缓解时间、血肿消失时间均短于对照组(P＜0.01).IVIG组下腹刺痛、月经感、腰酸发生率明显低于对照组(P＜0.05).IVIG组妊娠成功率为 84.91%(45/53)高于对照组的 64.58%(31/48)(P＜0.05).IVIG组早产发生率、早产儿死亡率、新生儿重症监护病房入住率均低于对照组(P＜0.01).结论 IVIG对RSA并SCH有明显的疗效,可增强免疫调节功能,改善免疫学指标及母婴结局.
Abstract
Objective To analyze the effect of intravenous immunoglobulin(IVIG)in the treatment of recurrent spontaneous abortion(RSA)complicated with subchorionic hematoma(SCH)and its effect on maternal and infant outcomes.Methods In total,101 patients with RSA and SCH were selected from March 2020 to March 2021 and divided into IVIG treatment group(n = 53)and control group(n = 48)according to different treatment methods.Immunological indicators[tumor necrosis factor-α(TNF-α),interleukin-10(IL-10),B-lymphocytes,natural killer cells(NK),thyroid peroxidase antibodies,complement 3(C3),complement 4(C4),immunoglobulin A(IgA),IgG,IgM],symptom improvement indica-tors,adverse reactions,and maternal and infant outcomes were analyzed before and after treatment.Results Compared with those before treatment,the levels of B-lymphocytes,NK cells,thyroid peroxidase antibody,IgA,IgG,IgM and TNF-α were significantly decreased in the two groups,while the levels of C3,C4 and IL-10 were significantly increased in IVIG group,and the changes in IVIG group were more significant(P＜0.05,P＜0.01).The duration of vaginal bleeding,time to symp-tom relief and time to hematoma disappearance in IVIG group were shorter than those in control group(P＜0.01).The inci-dence of lower abdominal tingling,menstruation and lower back soreness in IVIG group was significantly lower than that in control group(P＜0.05).The success rate of pregnancy in IVIG group was 84.91%(45/53),which was higher than that in control group[64.58%(31/48)](P＜0.05).The incidence of premature birth,the mortality rate of premature infants and the hospitalization rate of neonatal intensive care unit in IVIG group were lower than those in control group(P＜0.01).Con-clusion IVIG has obvious curative effect on RSA and SCH,which can enhance immunomodulatory function,improve immu-nological index and maternal and infant outcome.
基金项目
山东省医药卫生科技发展计划项目(202005020213)
国家科技期刊平台
NSTL
万方数据