孕激素维持妊娠及防治产科并发症新进展

New progress on progesterone maintaining pregnancy and preventing obstetric complications

孕激素是维持妊娠所必需,在内膜转化、胚胎着床、母-胎免疫及子宫收缩方面均起到重要的调节作用。长久以来,孕激素作为先兆流产的治疗方法,疗效一直存在争议,最近的荟萃分析由于入组的高质量研究有限仍无法得出确切的结论。相反,孕激素在复发性流产患者中的疗效得到大部分文献的肯定和支持。此外,随着孕激素维持妊娠机制的研究深入,部分研究开始将孕激素应用于一些新的领域并显示出一定的效果,例如防治早产、预防妊娠期高血压及治疗胎儿宫内生长受限等。本文综述孕激素的作用机制及其在临床的应用情况,并对其给药途径进行简单比较。

Progesterone is necessary for the maintenance of pregnancy,and it also plays an important regulatory role in endometrial transformation, embryo implantation, maternal-fetal immunity and uterine contractions. For a long time,the progesterone efficacy as a treatment for threatened miscarriage has been controversial,and recent meta-analyses have failed to draw definite conclusions due to limited high quality research. In contrast, the efficacy of progesterone in treating patients with recurrent miscarriage is supported by most of the literatures. In addition, according to the publication of in-depth study, progesterone has been applied to new areas and shows some effects, such as prevention or treatment of preterm birth, gestational hypertension and fetal intrauterine growth restriction. This article reviews the effective mechanism of progesterone and its clinical application and compares different routes of its administration.