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维生素D结合主动免疫治疗免疫复发性流产临床效果

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目的:观察维生素D结合主动免疫治疗免疫复发性流产临床效果.方法:回顾性分析2020年1月—2022年8月本院收治的免疫复发性流产患者200例临床资料,根据治疗方法分为观察组(100例)与对照组(100例),对照组采取低分子肝素钙注射液及黄体酮注射液治疗,观察组采取维生素D结合主动免疫治疗,比较两组治疗后流产率、妊娠12周时子宫动脉血流指标、孕4周及12周性激素水平、凝血功能指标、血清炎症因子指标、妊娠成功者妊娠结局、不良反应.结果:观察组流产率(4.1%)低于对照组(16.3%),孕12周时观察组子宫动脉血流搏动指数(1.19±0.25)及阻力指数(0.53±0.22)、收缩压/舒张压比值(3.20±0.29)均低于对照组(1.39±0.36、0.72±0.27、3.51±0.33),孕酮(62.65±3.21 nmol/L)及人绒毛膜促性腺激素(91117.36±33.26 U/L)高于对照组(56.23±4.03 nmol/L、79568.23±29.56 U/L),纤维蛋白原(2.33±0.23 g/L)及 D-二聚体(151.65±9.62μg/L)低于对照组(3.14±0.26 g/L、221.52±10.65μg/L),C 反应蛋白(16.26±2.99 mg/L)及白介素-6(48.26±2.85 ng/L)低于对照组(21.01±3.37 mg/L、51.23±3.41 ng/L),妊娠成功者足月妊娠(98.0%)高于对照组(91.2%)(均P<0.05),不良反应与对照组(0、2.0%)无差异(P>0.05).结论:维生素D结合主动免疫治疗免疫复发性流产临床效果良好,可降低患者流产率,改善孕妇凝血功能、性激素水平,降低炎症因子水平,改善妊娠结局,安全可靠.
Clinical effect of vitamin D combined with active immunotherapy for patients with immune recurrent spontaneous abortion
Objective:To observe the clinical effect of vitamin D combined with active immunotherapy for patients with immune recurrent spontaneous abortion.Methods:The clinical data of 200 patients with immune recurrent spontane-ous abortion from January 2020 to August 2022 were analyzed retrospectively.These patients were divided into obser-vation group(100 cases)and control group(100 cases)according to the different treatment methods.The patients in the control group were treated with low molecular weight heparin calcium injection combined with progesterone injec-tion,while the patients in the observation group were treated with vitamin D combined with active immunotherapy.The abortion rate,the values of the uterine artery blood flow indexes during 12 gestational weeks,the sex hormone levels during 4 and 12 gestational weeks changes in early pregnancy(about 1 month of gestation)and 12 gestational weeks,the values of the coagulation function indexes and the serum inflammatory factor indexes,the pregnancy out-comes of successful pregnancy and the adverse reactions of the patients after treatment were compared between the two groups.Results:The spontaneous abortion rate(4.1%)of the patients in the observation group was significantly lower than that(16.3%)of the patients in the control group.the values of uterine artery flow indexes,such as the pulse in-dex(PI,1.19±0.25),the resistance index(RI,0.53±0.22)and the ratio of systolic blood pressure/diastolic blood pressure(S/D,3.20±0.29)during the 12 gestational weeks of the patients in the observation group were significantly lower than those(1.39±0.36,0.72±0.27 and 3.51±0.33)of the patients in the control group.The levels of progester-one(62.65±3.21 nmol/L)and the human chorionic gonadotropin(91117.36±33.26 IU/L)of the patients in the ob-servation group were significantly higher than those(56.23±4.03 nmol/L and 79568.23±29.56 IU/L)of the patients in the control group.The levels of fibrinogen(2.33±0.23 g/L),D-dimer(151.65±9.62μg/L),C-reactive protein(16.26±2.99 mg/L)and interleukin-6(48.26±2.85 ng/L)of the patients in the observation group were significantly lower than those(3.14±0.26 g/L,221.52±10.65μg/L,21.01±3.37 mg/L and 51.23±3.41 ng/L)of the patients in the control group.The successful pregnancy to full term rate(98.0%)of the patients in the observation group was sig-nificantly higher than that(91.2%)of the patients in the control group(P<0.05).There was no significant difference in the adverse reactions(0 vs.2.0%)of the patients between the two groups(P>0.05).Conclusion:Vitamin D com-bined with active immunotherapy for treating the patients with immune recurrent spontaneous abortion has good clini-cal effect,which can reduce the abortion rate and the levels of inflammatory factors,improve the coagulation function,hormone levels and pregnancy outcomes of the patients,and with the high safety and reliability.

Immune recurrent abortionVitamin DActive immunityAbortion rateSex hormoneCoagulation functionInflammatory factorUterine artery flowPregnancy outcomes

张亚琴、李珍、康丽荣、张婧

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山西省儿童医院,山西省妇幼保健院(太原,030001)

免疫复发性流产 维生素D 主动免疫 流产率 性激素 凝血功能 炎症因子 子宫动脉血流 妊娠结局

2024

中国计划生育学杂志
国家人口计生委科学技术研究所

中国计划生育学杂志

CSTPCD
影响因子:1.759
ISSN:1004-8189
年,卷(期):2024.32(9)