低分子肝素钙辅助治疗复发性流产效果及对患者血清COX-2、IL-33水平影响

Efficacy of low molecular weight heparin calcium for adjuvant treating women with recurrent abortion and its effects on their cyclooxygenase 2 and interleukin 33 levels

目的:探讨低分子肝素钙辅助治疗复发性流产的疗效及对血清环氧化酶2(COX-2)、白细胞介素33(IL-33)的影响。方法:选择2019年1月-2021年1月在本院接受治疗的复发性流产患者121例,随机数表法分为联合组(n=61)和单药组(n=60),两组均给予阿司匹林治疗,联合组辅助给予低分子肝素钙联合阿司匹林治疗。比较两组临床疗效、血清COX-2、IL-33、雌二醇(E_(2))、孕酮(P)、绒毛膜促性腺激素(β-HCG)、D-二聚体(D-D)、纤溶酶原激活物抑制物1(PAI-1)、纤维蛋白原水平变化及不良反应发生情况。结果:治疗后,联合组总有效率(83.61%)高于单药组(66.67%),血清COX-2、IL-33水平两组均上升且联合组(525.47±67.19 U/L、1318.15±398.61 ng/L)高于单药组(444.94±76.05U/L、1017.79±150.16 ng/L),血清E_(2)、P、β-HCG水平两组均上升且联合组高于单药组,两组血清D-D、PAI-1、纤维蛋白原均两组均下降且联合组(121.34±26.55μg/L、0.51±0.23 AU/ml、2.13±0.24 g/L)低于单药组(187.97±35.23μg/L、0.95±0.28 AU/ml、4.11±0.35 g/L)(均P<0.05);不良反应总发生率联合组(8.2%)与单药组(11.7%)无差异(P>0.05)。结论:复发性流产患者应用低分子肝素钙辅助治疗疗效提高,安全性好,可能与有效改善COX-2、IL-33水平有关。

Objective:To study the efficacy of low molecular weight heparin calcium for adjuvant treating women with recurrent abortion,and to study its effects on their cyclooxygenase 2(COX-2)and interleukin 33(IL-33)levels.Methods:121 women with recurrent abortion were selected and were divided into two groups by random number table method from January 2019 to January 2021.61 women in the study group were given aspirin combined with low molecular weight heparin calcium treatment,and 60 women in the control group were given aspirin only.The clinical efficacy,the changes of the levels of serum COX-2,IL-33,estradiol(E_(2)),progesterone(P),chorionic gonadotropin(β-HCG),and D-dimer(D-D),the plasminogen activator inhibitor 1(PAI-1)and fibrinogen levels,and the incidence of adverse reactions of the women were compared between the two groups.Results:After treatment,the total effective rate(83.6%)of the women in the study group was significantly higher than that(66.7%)of the women in the control group.The serum levels of COX-2 and IL-33(525.47±67.19 U/L and 1318.15±398.61 ng/L)of the women in the study group were significantly higher than those of the women(444.94±76.05U/L and 1017.79±150.16 ng/L)in the control group.The serum E_(2),P,andβ-hCG levels of the women in both groups had increased significantly,and which of the women in the study group was significantly higher than that of the women in the control group.The serum levels of D-D,PAI-1,and fibrinogen of the women in the two groups had decreased significantly,and which(121.34±26.55μg/L,0.51±0.23 AU/ml,and 2.13±0.24 g/L)of the women in the study group were significantly lower than those(187.97±35.23μg/L,0.95±0.28 AU/ml,and 4.11±0.35 g/L)of the women in the control group(all P<0.05).There was no significant difference in the total incidence of adverse reactions(8.2%vs.11.7%)of the women between the two groups(P>0.05).Conclusion:Low molecular weight heparin calcium as adjuvant therapy for the women with recurrent abortion can improve the effect with good safety,which may be related to the effectively improvement of COX-2 and IL-33 levels.