低分子肝素治疗复发性流产的疗效及对肝功能的影响

Effect of Low Molecular Weight Heparin on Recurrent Spontaneous Abortion and its Influence on Liver Function

目的探讨低分子肝素(low molecular weight heparin,LMWH)治疗复发性流产的疗效及对患者肝功能水平及凝血功能的影响。方法选择惠阳三和医院2019年1月—2020年1月诊断为因子宫动脉原因导致的复发性流产的患者86例,按照入院顺序分对照组(42例)和治疗组(44例)。对照组患者接受基础治疗,治疗组患者接受LMWH治疗。比较两组患者的临床疗效、肝功能、凝血功能指标及不良反应。结果治疗组患者早产率低于对照组(P<0.001),足月产率高于对照组(P<0.001);而活产率和流产率差异比较无统计学意义(P>0.05)。治疗后,两组患者谷丙转氨酶(alanine aminotransferase,ALT)和谷草转氨酶(aspartate aminotransferase,AST)水平较治疗前升高,且治疗组患者ALT和AST水平高于对照组(P<0.001)。治疗后,两组患者部分凝血酶原时间(activated partial thromboplastin time,APTT)较治疗前升高,纤维蛋白原(fibrinogen,FIB)和血浆组织纤溶酶原激活因子(tissue plasminogen activator,t-PA)水平较治疗前下降;且治疗组患者APPT水平高于对照组(P<0.001),FIB和t-PA水平低于对照组(P<0.001)。治疗组患者不良反应率低于对照组(P<0.05)。结论LMWH治疗复发性流产患者能提升疗效,改善其肝功能和凝血功能,且安全性较好。

Objective To investigate the effect of low-molecular weight heparin on recurrent spontaneous abortion and its influence on liver function.Methods 86 patients with recurrent abortion caused by uterine artery in Huiyang Sanhe Hospital from January 2019 to January 2020 were selected.According to the order of admission,they were divided into control group(42 cases)and treatment group(44 cases).The control group received basic treatment,and the treatment group received lowmolecular-weight heparin.The clinical efficacy,liver function,coagulation function and adverse reactions were compared between the two groups.Results The preterm birth rate of the treatment group was lower than that of the control group(P<0.001),and the full-term birth rate was higher than that of the control group(P<0.001),but there was no significant difference in the live birth rate and abortion rate(P>0.05).After treatment,the levels of ALT and AST in the two groups were higher than those before treatment,and the levels of ALT and AST in the treatment group were higher than those in the control group(P<0.001).After treatment,the APPT of the two groups was higher than that before treatment,and the FIB and t-PA levels were lower than before treatment;the APPT level of the treatment group was higher than those of the control group(P<0.001),and the FIB and t-PA levels were lower than those of the control group(P<0.001).The adverse reaction rate of the treatment group was lower than that of the control group(P<0.05).Conclusion Low-molecular-weight heparin in the treatment of patients with recurrent abortion can improve the curative effect,improve the liver function and coagulation function,and the safety is good.