静脉注射免疫球蛋白治疗继发习惯性流产患者的疗效探析

Curative effect of intravenous immunoglobulin in treating patients with secondary recurrent miscarriage

目的:妊娠早期静脉输注免疫球蛋白(IVIG)对继发性惯性流产患者活产率的影响。方法:纳入87例(初始纳入92例)继发习惯性流产患者,随机性分为两组,其中45例患者(IVIG组)重复性给予IVIG,42例(安慰剂组)给予重复性输注安慰剂(白蛋白),记录主要临床结局即新生儿安全出生情况,统计学分析IVIG对临床结局的影响。结果 IVIG组和安慰剂组继发性习惯性流产患者活产率分别为48.9%(22/45)和47.6%(20/42),两组差异不显著(P=0.923);分娩时IVIG组中位妊娠时间显著性高于安慰剂组(282.4d vs.272.1d,P=0.001),但是IVIG组平均出生体重显著性高于安慰剂组(3305.4±293.6 vs.3299.5±312.1,P=0.471)。结论:IVIG并未增加继发性习惯性流产患者活产率,因此并不推荐广泛用于临床实践治疗。

Objectives： To determine the effect of infusions with intravenous immunoglobulin （IVIG） during early pregnancy on the effect of live birth rate in women with secondary recurrent miscarriage. Methods： 87 sec- ondary recurrent miscarriage women （initially 92 cases） were enrolled and randomly assigned to two groups, the IVIG group （45 cases） was repeated infusions with WIG and placebo group （42 cases with albumin） was given pla- cebo. The birth rates calculated by the intention to - treat analysis were 48.9% （22/45） and 47.6% （20/42） in the IVIG and placebo group, respectively, without significant differences between the two groups （P = 0. 923）. The median gestational length at delivery was higher in the IVIG than the placebo group （282.4 versus 272. 1 days, P = 0. 001 ）, but the mean birth weights were not significantly different between the two groups （ 3305.4 ± 293.6 versus 3299. 5 ±312. 1, P =0. 471 ）. Conclusion： IVIG does not increase the live birth rate in patients with secondary re- current miscarriage so it is not generally recommended in clinical practice.