黄体酮联合地屈孕酮对高龄先兆流产患者血清人绒毛膜促性腺激素、孕酮水平及妊娠结局的影响

Effect of progesterone combined with dydrogesterone on serum human chorionic gonadotropin,progesterone levels and pregnancy outcome in the elderly patients with threatened abortion

目的探讨黄体酮联合地屈孕酮对高龄先兆流产患者血清人绒毛膜促性腺激素(HCG)、孕酮(Pro)水平及妊娠结局的影响。方法选取2017年6月至2019年6月高龄先兆流产患者180例,依据随机数字表法分为黄体酮组、地屈孕酮组和联合组,每组60例。黄体酮组予黄体酮20 mg,im,qd×14 d;地屈孕酮组予地屈孕酮40 mg,po,qd×14 d;联合组给予黄体酮联合地屈孕酮治疗。比较3组生化指标(血清HCG、Pro水平)、临床症状缓解时间、妊娠结局和不良反应。结果3组治疗7、14 d后血清HCG、Pro水平均明显高于同组治疗前,且联合组明显高于黄体酮组和地屈孕酮组,差异有统计学意义(P<0.05)。联合组腹痛、腰酸和出血等临床症状缓解时间明显短于黄体酮组和地屈孕酮组,差异有统计学意义(P<0.05);保胎成功率、新生儿体质量和Apgar评分明显高于黄体酮组和地屈孕酮组,差异有统计学意义(P<0.05)。3组不良反应发生率相当,差异无统计学意义(P>0.05)。结论黄体酮联合地屈孕酮可有效改善高龄先兆流产患者血清HCG、Pro水平及临床症状,有利于改善妊娠结局,且安全性好,值得临床推广。

AIM To discuss the effect of progesterone combined with dydrogesterone on serum human chorionic gonadotropin(HCG),progesterone(Pro)levels and pregnancy outcome in the elderly patients with threa-tened abortion.METHODS Totally 180 advanced age patients with threatened abortion were selected from June 2017 to June 2019,and they were divided into progesterone group,dydrogesterone group and combined group according to the random number table method,with 60 patients in each group.The progesterone group was treated with intramuscular injection of 20 mg progesterone,qd,for 14 d;the dydrogesterone group was treated with oral administration of 40 mg dydrogesterone,qd,for 14 d;the combined group was treated with progesterone combined with dydrogesterone.The biochemical indexes(serum HCG,Pro level),relief time of clinical symptom,pregnancy outcome and adverse drug reactions were compared among 3 groups.RESULTS The serum HCG and Pro levels in the progesterone group,dydrogesterone group and combined group at 7 and 14 d after treatment were significantly higher than those before treatment,the serum HCG and Pro levels in the combined group at 7 and 14 d after treatment were significantly higher than those in the progesterone group and dydrogesterone group,and the difference was statistically significant(P<0.05).The relief time of abdominal pain,soreness of waist,hemorrhage and other clinical symptoms in the combined group was significantly shorter than that in the progesterone group and dydrogesterone group,and the difference was statistically significant(P<0.05).The success rate of fetal protection,neonatal weight and Apgar score in the combined group were significantly higher than those in the progesterone group and dydrogesterone group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse drug reactions among 3 groups(P>0.05).CONCLUSION Progesterone combined with dydrogesterone can effectively improve the serum HCG,Pro levels and clinical symptoms in the elderly patients with threatened abortion,which is helpful to improve the pregnancy outcome,and it is safety and worth for further clinical promotion.