低分子肝素治疗产科抗磷脂综合征疗效分析

Effect analysis of low molecular weight heparin in treatment of obstetrical antiphospholipid syndrome

目的分析产科抗磷脂综合征(antiphospholipid syndrome,APS)应用低分子肝素治疗的临床效果及安全性。方法于天津市第一中心医院2019年1月—2020年5月收治的APS患者中选取80例,随机分为研究组和对照组各40例,其中两组ACA阳性已孕患者分别为25例和26例,对照组常规应用强的松与阿司匹林治疗,研究组采用低分子肝素治疗,观察两组疗效。结果治疗两个疗程后,两组抗心磷脂抗体转阴率均明显提高,但组间转阴率差异无统计学意义(P>0.05)。治疗3个疗程后,两组抗心磷脂抗体转阴率高于治疗1个疗程和两个疗程,研究组转阴率85.00%,与对照组的87.50%比较,差异无统计学意义(P>0.05)。研究组治疗两个疗程后的血浆黏度、血钙浓度、TRACP水平与对照组比较,具有显著性差异(P<0.05)。研究组妊娠成功率为52.00%,对照组妊娠成功率57.69%,差异无统计学意义(P>0.05)。研究组并发症发生率为7.50%,显著低于对照组的30.00%,组间对比有统计学意义(P<0.05)。结论低分子肝素治疗APS的疗效与强的松和阿司匹林疗效相当,但更有助于降低患者血液黏度,对患者骨代谢影响更小,并发症少,具有较高安全性,值得推广。

Objective To analyze the clinical effect and safety of low molecular weight heparin(LMWH)in the treatment of obstetrical antiphospholipid syndrome(APS).Methods Totally 80 APS patients admitted to our hospital from January 2019 to January 2020 were randomly divided into study group and control group,with 40 patients in each group,including 25 and 26 aca-positive pregnant patients,respectively.The control group was routinely treated with prednisone and aspirin,and the study group was treated with low-molecular-weight heparin.Results After 2 courses of treatment,the negative conversion rate of anticardiolipin antibody in the two groups was significantly increased,but there was no difference in the negative conversion rate between the two groups(P>0.05).After 3 courses of treatment,the negative conversion rate of anti-cardiolipin antibody in the two groups was higher than that in 1 and 2 courses of treatment,and the negative conversion rate in the study group was 85.00%,compared with 87.50%in the control group,with no statistically significant difference(P>0.05).Plasma viscosity,blood calcium concentration and TRACP levels in the study group after 2 courses of treatment were significantly different from those in the control group(P<0.05).The pregnancy success rate was 52.00%in the study group and 57.69%in the control group,with no significant difference(P>0.05).The incidence of complications in the study group was 7.50%,significantly lower than that in the control group(30.00%),P<0.05.Conclusion The therapeutic effect of LMWH on APS is better than that of prednisone and aspirin,but it is more helpful to reduce patients’blood viscosity,has less impact on patients’bone metabolism,has fewer complications,and has higher safety,which is worthy of promotion.