黄体酮辅治因黄体功能不全致先兆流产对孕酮及预后的影响

Influence of Progesterone on Progesterone and prognosis of threatened abortion caused by luteal insufficiency

目的研究不同剂型的黄体酮对黄体功能不全致先兆流产孕妇孕酮(P)及预后的影响。方法选取2019年2月至2020年2月九江市第三人民医院收治的58例因黄体功能不全致先兆流产患者作为研究对象,按照信封密封方法将其分为观察组与对照组,每组各29例。观察组患者采用口服黄体酮治疗,对照组患者采用肌内注射黄体酮治疗,治疗10 d。比较两组患者的疗效、P、血清β-人绒毛膜促性腺激素(β-hCG)、P诱导的封闭因子(PIBF)、血清细胞因子水平及保胎成功率。结果两组患者的临床总有效率比较,差异无统计学意义(P>0.05)。治疗后,观察组患者的P、β-hCG、PIBF水平高于对照组,差异有统计学意义(P<0.05)。两组患者的保胎成功率比较,差异无统计学意义(P>0.05)。治疗后,观察组患者的γ干扰素(IFN-γ)水平低于对照组,白细胞介素-4(IL-4)、白细胞介素-8(IL-8)、调节蛋白因子(RANTES)水平高于对照组,差异有统计学意义(P<0.05)。结论口服与肌内注射黄体酮治疗因黄体功能不全致先兆流产的效果相差不大,但治疗方式便捷,可促进生殖激素恢复正常,临床可按照产妇实际情况采取合适的用药方式。

Objective To study the effect of different dosage forms of Progesterone(P)on progesterone and prognosis of pregnant women with threatened abortion caused by luteal insufficiency.Methods From February 2019 to February 2020,58 patients with threatened abortion due to corpus luteal insufficiency treated by the Third People′s Hospital of Jiujiang City were selected as the research objects.According to the envelope sealing method,they were divided into observation group and control group,with 29 cases in each group.The observation group was treated with oral Progesterone,and the control group was treated with intramuscular injection of Progesterone,with 10 days.The efficacy,P,serumβ-human chorionic gonadotropin(β-hCG),serum cytokine levels,progesterone-induced blocking factor levels(PIBF)and the success rate of pregnancy loss were compared between the two groups.Results There was no statistically significant difference in total clinical effective rate between the two groups(P>0.05).After treatment,the levels of P,β-hCG and PIBF in observation group were higher than those in control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the success rate of fetal preservation between the two groups(P>0.05).After treatment,the level of interferon-γ(IFN-γ)in observation group was lower than that of the control group,and the levels of interleukin-4(IL-4),interleukin-8(IL-8)and regulated upon activation normal T cell expressed and secreted factor(RANTES)were higher than those of the control group,the differences were statistically significant(P<0.05).Conclusion Oral and intramuscular injection of Progesterone in the treatment of threatened abortion due to luteal insufficiency has little difference in effect,but the treatment is convenient and can promote the return of reproductive hormones to normal.Clinically,appropriate medication can be adopted according to the actual situation of puerpera.