主动免疫联合烯丙雌醇治疗原因不明反复自发性流产的临床疗效评估

Evaluation of clinical efficacy of combination of active immunotherapy and allylestrenol in treatment of patients with unexplained recurrent spontaneous abortion

目的 :评价主动免疫联合烯丙雌醇 (allylestre nol)治疗原因不明反复自发性流产 (URSA)的临床疗效 ,为临床原因不明反复自发性流产的治疗寻求最佳方案。方法 :4 35例原发性原因不明反复自发性流产患者分为 3组。联合治疗组 185例 ,接受主动免疫联合烯丙雌醇治疗 ;主动免疫组 15 2例 ,单纯接受主动免疫治疗 ;烯丙雌醇组 98例 ,只接受烯丙雌醇治疗 ;另有 96例继发性原因不明反复性流产患者 ,为继发URSA组 ,全部接受主动免疫联合烯丙雌醇治疗。结果 :联合治疗组妊娠成功率为 92 .0 5 % ,主动免疫组为 71.4 3% ,烯丙雌醇组为 31.5 1% ,继发URSA组为 86 .76 % (P <0 .0 1)。联合治疗对原发和继发URSA的疗效相近 (P >0 .0 5 )。结论 :在本研究中主动免疫联合烯丙雌醇治疗原因不明反复自发性流产疗效最好 ,值得在临床推广应用。

AIM: To evaluate the clinical efficacy of combination of active immunotherapy and allylestrenol in treatment of patients with unexplained recurrent spontaneous abortion (URSA) and to investigate a best therapeutic method in treatment of patients with URSA. METHODS: 435 patients with primary URSA were randomly assigned to three groups: 185 in combination medication group which was treated with active immunotherapy and allylestrenol, 152 in active immunotherapy group which was only treated with active immunotherapy, 98 in allylestrenol group which was only treated with allylestrenol. 96 secondary URSA in secondary URSA group were treated with active immunotherapy and allylestrenol. RESULTS: The successful pregnant rates of combination medication group, active immunotherapy group, allylestrenol group and secondary group were 92.05 %, 71.43 %, 31.51 % and 86.76 %, respectively. The successful pregnant rate in combination group were higher than that in the active immunotherapy group and the allylestrenol group (P< 0.01 ), but there was no significant difference between combination group and the secondary URSA group (P> 0.05 ). CONCLUSION: Combination of active immunotherapy and allylestrenol is better than other therapy method in treatment of patients with URSA, which is worth further widespread application in clinical practice.