黄体酮联合低分子肝素钠治疗复发性流产疗效观察

Efficacy of Progesterone Combined with Low Molecular Weight Heparin Sodium in the Treatment of Recurrent Abortion

目的探讨黄体酮联合低分子肝素钠治疗复发性流产的临床疗效及对血清性激素、凝血指标、Toll样受体4(TLR4)及核因子-κB p65(NF-κB p65)的影响。方法选取医院2015年5月至2017年7月收治的复发性流产患者98例,依据治疗方式差异分为两组,各49例。对照组予黄体酮治疗,试验组予黄体酮联合低分子肝素钠治疗。结果治疗后,试验组雌二醇(E2)为(455.16±37.70)ng/L,绒毛膜促性腺激素(HCG)为(6 850.17±750.26)U/L,孕酮(P)为(28.02±3.05)μg/L,分别高于对照组的(413.27±41.33)ng/L、(6 118.26±746.57)U/L及(21.70±2.97)μg/L(P<0.05);试验组纤维蛋白原(FIB)低于对照组,活化部分凝血活酶时间(APTT)、凝血酶时间(TT)及凝血酶原时间(PT)均高于对照组(P<0.05);试验组mRNA TLR4及NF-κB p65均低于对照组,NF-κB p65及TLR4蛋白检测灰度值均高于对照组(P<0.05);试验组分娩结局优于对照组(P<0.05)。结论黄体酮联合低分子肝素钠治疗复发性流产疗效确切,有助于改善性激素、凝血指标、TLR4及NF-κB p65。

Objective To investigate the clinical efficacy of progesterone combined with low molecular weight heparin sodium in the treatment of recurrent abortion and its effect on serum sex hormone,coagulation parameters,toll-like receptor 4(TLR4)and nuclear factor-κB p65(NF-κB p65).Methods Totally 98 patients with recurrent abortion admitted to our hospital from May 2015 to July2017 were selected and divided into two groups according to the different treatment methods,49 cases in each group.The patients in the control group were treated with progesterone,while the patients in the experimental group were treated with progesterone combined with low molecular weight heparin sodium.Results After treatment,the estradiol(E2),human chorionic gonadotropin(HCG)and progesterone(P)in the experimental group were(455.16±37.70)ng/L,(6 850.17±750.26)U/L and(28.02±3.05)μg/L,which were higher than(413.27±41.33)ng/L,(6 118.26±746.57)U/L and(21.70±2.97)μg/L in the control group(P<0.05).The fibrinogen(FIB)in the experimental group was lower than that in the control group,while the activated partial thromboplastin time(APTT),thrombin time(TT)and prothrombin time(PT)in the experimental group were longer than those in the control group(P<0.05).The expression levels of mRNA TLR4 and NF-κB p65 in the experimental group were lower than those in the control group,while the expression levels of detection grey value of NF-κB p65 and TLR4 proteins were higher than those in the control group(P<0.05).The delivery outcome in the experimental group was better than that in the control group(P<0.05).Conclusion Progesterone combined with low molecular weight heparin sodium is effective in the treatment of recurrent abortion.It is helpful to improve sex hormone,coagulation parameters,TLR4 and NF-κB p65.