主动免疫联合地屈孕酮治疗复发性流产患者的疗效及对LP、ADPN表达的影响

Effect of active immunization combined with dydrogesterone on recurrent spontaneous abortion and its effect on LP and ADPN expression

目的 探索主动免疫联合地屈孕酮治疗复发性流产患者的疗效及对血清瘦素（LP）、脂联素（ADPN）表达的影响。方法选取2014年1月~2015年12月浙江省宁波市奉化人民医院住院部及门诊部收治的反复流产的51例孕妇,并取正常妊娠孕妇50例及正常未孕女性50例作为对照对象。根据治疗方法的不同,将复发性自然流产组患者分为联合组（n=26）及单药组（n=25）。治疗前后分别抽取静脉血测定LP、ADPN及β-HCG水平,并记录成功妊娠例数。结果 测定3组女性血清中LP、ADPN水平,组内两两比较,差异均有统计学意义（P〈0.05）。复发性自然流产组孕妇血清中β-HCG含量（3 914.5±2 548.2）m IU,正常妊娠组则为（7124.5±2 847.6）m IU,2组比较差异有统计学意义（P〈0.05）。治疗后,联合组LP、ADPN及β-HCG水平明显升高,且成功妊娠高达88.46%,优于单药组水平,差异有统计学意义（P〈0.05）。结论 血清LP、ADPN水平较低的孕妇易发生复发性自然流产,通过主动免疫联合地屈孕酮治疗,可明显改善激素水平,提高妊娠成功率。

Objective To investigate the efficacy of active immunization combined with dydrogesterone in the treatment of recurrent spontaneous abortion, and the expression of serum leptin （ LP） and adiponectin （ADPN）. Methods 5 1 c a s e s of inpatient a n d o u t patient t r e a t m e n t of r e p e a t e d abortion of 51 pregnant women from January 2014 to December 2015 in Ningbo Fenghua Peopled Hospital of Zhejiang Province were selected, and 50 cases of normal pregnant women and normal nonpregnant women 50 cases as a control object. Depending on the treatment method, patients with recurrent spontaneous abortion were divided into combination group （ n, = 26 ） and monotherapy group （ n, = 25 ） . The levels of LP, ADPN and （3-HCG were measured before and after treatment, and the number of successful pregnancies. Results T h e levels o f LP a n d ADPN in s e r u m w e r e m e a s u r e d in three groups of women, there were statistically significant differences between the two groups （ P 〈0. 05 ）. The serum levels of （3-HCG in the pregnant women with recurrent spontaneous abortion group were （3 914. 5 ± 2 548. 2） mlU, and the normal pregnancy group was （7 124. 5 ± 2 847. 6） mlU, the difference was statistically significant （ P 〈 0. 05 ）. After treatment, the levels of LP, ADPN and （3-HCG in the combination group were significantly increased, and successful pregnancy as high as 88. 46% , better than the level of monotherapy group, the difference was statistically significant （ P 〈 . 05）. Conclusion Serum LP, ADPN lower levels of pregnant women prone to recurrent spontaneous abortion, through active immunization combined with dexamethasone treatment, can significantly improve the hormone level, improve the success rate of pregnancy.