低分子肝素联合丙种球蛋白对复发性流产的保胎效果观察及对激素水平的影响

Effect of Low Molecular Weight Heparin Combined with Gammaglobulin on Fetal Preservation of Recurrent Abortion and Its Effect on Hormone Level

目的观察低分子肝素与丙种球蛋白对复发性流产的保胎效果及对激素水平的影响。方法回顾性分析2016年1月至2017年8月在我院接受保胎治疗的复发性流产患者的临床资料,根据其保胎方式分为对照组和观察组,对照组给予常规保胎治疗,观察组给予低分子肝素联合丙种球蛋白保胎治疗。观察两组患者的保胎成功率,比较两组患者激素、细胞因子水平和妊娠结局的差异。结果观察组患者保胎成功率为95.00%,明显高于对照组,差异有统计学意义(χ~2=6.275,P=0.012);两组患者治疗前激素水平差异无统计学意义(P>0.05),治疗后,观察组β-HCG、黄体酮和E2水平高于对照组,差异有统计学意义(P<0.05);两组患者治疗前细胞因子水平差异无统计学意义(P>0.05),治疗后观察组IL-10和IL-17水平低于对照组,差异有统计学意义(t=5.951、9.268,P<0.001);两组患者治疗前免疫功能差异无统计学意义(P>0.05),治疗后,观察组患者的IgG、IgA和IgM水平高于对照组,差异有统计学意义(t=-5.828、-4.135、-2.212,P<0.05);两组患者顺利分娩和活产率差异无统计学意义(χ~2=2.222、0.556,P=0.136、0.456)。结论予低分子肝素联合丙种球蛋白对复发性流产患者有较好的保胎效果,可明显改善患者的激素水平和免疫功能,降低炎性反应水平,具有良好的应用价值。

Objective To observe the effect of low molecular weight heparin and gamma globulin on fetal preservation and hormone level in recurrent abortion.Methods The clinical data of recurrent abortion patients who received fetal preservation treatment in our hospital from January 2016 to August 2017 were analyzed retrospectively and divided into control group and observation group according to the way of protecting the fetus. The control group was treated with routine fetal preservation,while the observation group received low molecular weight heparin combined with gamma globulin.The success rate of fetal preservation was observed and the difference of hormone,cytokine levels and pregnancy outcome was compared between the two groups.Results The success rate of fetal preservation in the observation group was 95.00%,which was significantly higher than that in the control group(χ^2 = 6. 275,P = 0. 012);There was no significant difference in hormone levels between the two groups before treatment( P>0.05). After treatment,the levels of β-HCG,progesterone and E2 in the observation group were significantly higher than those in the control group( P<0. 05);There was no significant difference in cytokines between the two groups before treatment( P>0.05).After treatment,the levels of IL-10 and IL-17 in the observation group were lower than those in the control group,and the difference was statistically significant( t = 5.951、9.268,P<0.001);There was no significant difference in immune function between the two groups before treatment( P>0.05). After treatment,the levels of IgG,IgA and IgM in the observation group were significantly higher than those in the control group( t =-5.828、-4.135、-2.212,P< 0.05);There was no significant difference in the rate of delivery and live delivery between the two groups(χ^2 = 2. 222、0. 556,P = 0. 136、0. 456). Conclusion Low molecular weight heparin combined with immunoglobulin has a good effect on protecting the fetus in patients with recurrent abortion. It can obviously improve the hormone level and immune function of the patients and reduce the level of inflammatory reaction,which has a good application value.