阿司匹林联合低分子肝素钙治疗不明原因复发性流产临床研究

Clinical study of aspirin combined with low molecular weight heparin calcium in the treatment of unexplained recurrent spontaneous abortion

目的探讨对不明原因复发性流产(RSA)孕妇实施阿司匹林联合低分子肝素钙治疗的临床效果。方法 83例不明原因复发性流产孕妇作为复发性流产组,同期83例正常妊娠孕妇作为对照组。对照组给予常规治疗,复发性流产组在常规治疗的基础上给予阿司匹林联合低分子肝素钙治疗。对比两组治疗效果。结果复发性流产组孕妇凝血酶时间(TT)短于对照组,左脐动脉收缩期峰值和舒张末期流速比值(S/D)、左搏动指数(PI)、右PI均高于对照组,差异均具有统计学意义(t=2.920、4.871、4.483、4.082,P<0.05)。复发性流产组孕妇治疗后,TT长于治疗前,左S/D、右S/D值均低于治疗前,差异均具有统计学意义(t=4.006、5.123、2.022,P<0.05)。治疗过程中,复发性流产组不良反应发生率为42.17%(35/83),最终活产率为85.54%(71/83)。结论对不明原因复发性流产孕妇实施阿司匹林联合低分子肝素钙治疗效果显著,可以更好的改善孕妇的高凝状态。

Objective To discuss the clinical effect of aspirin combined with low molecular weight heparin calcium in the treatment of pregnant women with unexplained recurrent spontaneous abortion（RSA）. Methods There were 83 pregnant women with unexplained recurrent spontaneous abortion as recurrent spontaneous abortion group, and concurrent 83 pregnant women with normal pregnancy as control group. The control group received conventional therapy, and the recurrent spontaneous abortion group received combined therapy of aspirin and low molecular weight heparin calcium on the basis of conventional therapy. The treatment effect in two groups was compared. Results The recurrent spontaneous abortion group had shorter thrombin time（TT） than the control group, and higher left systolic velocity/diastolic velocity（S/D）, left pulsatility index（PI） and righet PI than the control group. Their difference was statistically significant（t=2.920, 4.871, 4.483, 4.082, P〈0.05）. After treatment, the recurrent spontaneous abortion group had longer TT than before treatment, and lower S/D, right S/D value than before treatment. Their difference was statistically significant（t=4.006, 5.123, 2.022, P〈0.05）. During treatment, the recurrent spontaneous abortion group had incidence of adverse reactions as 42.17%（35/83）, final live birth rate as 85.54%（71/83）. Conclusion Combination of aspirin and low molecular weight heparin calcium shows remarkable treatment effect for pregnant women with unexplained recurrent spontaneous abortion, and can better improve the hypercoagulable state of pregnant women.