低分子量肝素对不明原因复发性流产患者子宫动脉血流、免疫指标及激素水平的影响

Effect of low molecular weight heparin on uterine artery blood flow,immune index and hormone level of uterine artery in patients with unexplained recurrent abortion

目的探究低分子量肝素(LMWH)对不明原因复发性流产(RA)患者子宫动脉血流及免疫指标的影响。方法选取2018年5月至2020年12月江苏省淮安市妇幼保健院120例不明原因RA患者作为研究对象,按摸球法分为两组,每组各60例,对照组予以糖皮质激素、复合维生素口服治疗,观察组在对照组基础上加用LMWH治疗,治疗直至妊娠12周,比较两组妊娠7、10、12周时子宫动脉血流收缩期与舒张期血流比值(S/D)、搏动指数(PI)和阻力指数(RI)及免疫指标、保胎情况。结果12周治疗后,整体分析发现:S/D、PI、RI组间比较、时间点比较及交互作用差异均有统计学意义(P<0.05)。组内比较,两组组内各时间点比较,差异均有统计学意义(P<0.05),组间比较,妊娠12周时观察组S/D、PI、RI低于对照组,差异有统计学意义(P<0.05);两组γ干扰素(IFN-γ)、白细胞介素(IL)-2和IL-8治疗后均降低,且观察组低于对照组,差异有统计学意义(P<0.05);观察组保胎成功率高于对照组,差异有统计学意义(P<0.05)。结论LMWH可降低不明原因RA患者的子宫动脉血流阻力,调节免疫功能,提高保胎成功率。

Objective To explore the effects of low molecular weight heparin(LMWH)on uterine artery blood flow and immune indexes in patients with unexplained recurrent abortion(RA).Methods A total of 120 patients with unknown RA in Huaian Maternal and Child Health Hospital of Jiangsu Province from May 2018 to December 2020 were selected as the research subjects.They were divided into two groups according to the ball method,with 60 cases in each group.The control group received oral treatment with glucocorticoids and multivitamins,the observation group was treated with LMWH on the basis of the control group and treated until 12 weeks of gestation.The systolic to diastolic blood flow ratio systolic/diastolic(S/D),pulsatile index(PI),resistance index(RI),immune indexes and fetal preservation were compared between the two groups at 7,10 and 12 weeks of gestation.Results After 12 weeks of treatment,the overall analysis found that the differences between groups,time point comparisons,and interaction S/D,PI,and RI,and the differences were statistically significant(P<0.05).Intra-group comparison,the differences at each time point in the two groups,and the differences were statistically significant(P<0.05),in comparison between groups,S/D,PI and RI of the observation group were lower than those of the control group at 12 weeks of gestation,and the difference were statistically significant(P<0.05);interferon-γ(IFN-γ),interleukin(IL)-2 and IL-8 decreaseds in both groups,and observation group was lower than control group,and the differences were statistically significant(P<0.05);the success rate of fetus preservation in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion LMWH can reduce uterine artery blood flow resistance in patients with unknown RA,regulate immune function and improve the success rate of fetal preservation.