地屈孕酮片联合hCG对复发性流产患者激素水平及细胞因子的调节作用

Regulatory effect of dydrogesterone tablets combined with HCG on the level of hormone and cytokines of women with recurrent spontaneous abortion

目的:探讨地屈孕酮片联合人绒毛膜促性腺激素(hCG)对复发性流产患者激素水平及细胞因子的调节作用。方法:将2014年11月-2015年5月本院收治的复发性流产患者40例作为对照组,采用黄体酮联合hCG治疗;将2015年6月-2015年12月本院收治的复发性流产患者42例作为观察组,采用地屈孕酮片联合hCG治疗。于孕8周、12周进行激素水平及细胞因子测定,比较两组变化。结果:观察组的保胎成功率高于对照组,流产率及不良反应发生率低于对照组(P<0.05);孕12周,两组雌激素(E_2)、孕激素(P)、hCG均显著升高,且观察组高于对照组(P<0.05);两组白介素4(IL-4)升高,γ干扰素(INF-γ)、INF-γ/IL-4降低,且观察组IL-4高于对照组,INF-γ、INF-γ/IL-4低于对照组(P<0.05)。结论:地屈孕酮片联合hCG能显著提高复发性流产患者性激素水平,调节Th1/Th2细胞因子平衡,提高保胎率,降低不良反应发生。

Objective： To investigate the regulatory effect of dydrogesterone tablets combined with human chorionic gonadotropin （hCG） on hormone levels and cytokines of women with recurrent spontaneous abortion （RSA）. Methods： 40 women with RSA in Jinhua Central Hospital of Zhejiang from November 2014 to May 2015 were selected into con- trol group, which were treated by progesterone combined with hCG. Another 42 women with RSA in the hospital from June 2015 to December 2015 were selected into observation group, which treated by dydrogesterone tablets combined with hCG. The level of hormone and cytokines were measured at 8 weeks and 12 weeks, and the changes were com- pared between the two groups. Results： The success rate of prevent miscarriage in the observation group was higher than that in the control group. The abortion rate and the incidence of adverse reactions in the observation group were lower than those in the control group （P〈0.05）. At 12 weeks, the level of estrogen （E2）, progesterone （P） and hCG were significantly increased in the two groups （P〈0.05）. And the observation group was higher than the control group （P〈0.05）. In two groups ,the interleukin （IL-4） was increased, interferon （INF-γ）, INF-γ/IL-4 were reduced （P〈0.05）. And IL-4 in the observation group was higher than that in the control group. INF-γ, INF-γ/IL-4 in the observa- tion group was lower than that of the control group （P〈0.05）. Conclusion： Dydrogesterone tablets combined with hCG can significantly improve the hormone level of patients with recurrent spontaneous abortion, regulate the balance of Thl/Th2 cytokines, improve the rate of preventing miscarriage, reduce the occurrence of adverse reaction.