子宫动脉阻力增高复发性流产应用地屈孕酮治疗的临床效果

Clinical Effect of Dydrogesterone in the Application of Treatment of Recurrent Abortion with Increased Uterine Artery Resistance

目的:探讨子宫动脉阻力增高复发性流产应用地屈孕酮治疗的临床效果。方法:选取2020年6月-2021年6月河西学院附属张掖人民医院收治的86例子宫动脉阻力增高复发性流产患者为研究对象。随机将其分对照组和观察组,各43例。对照组给予阿司匹林治疗,观察组给予地屈孕酮治疗。比较两组治疗前后凝血功能指标、血流阻力学参数、性激素指标及妊娠结局。结果:治疗后,两组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)较治疗前延长,纤维蛋白原(FIB)水平较治疗前降低,观察组PT、APTT、TT均长于对照组,FIB水平低于对照组(P<0.05)。治疗后,两组搏动指数(PI)、阻力指数(RI)、脐动脉收缩期峰值和舒张末期流速之比(S/D)较治疗前降低,观察组PI、RI、S/D均低于对照组(P<0.05)。治疗后,两组β-人绒毛膜促性腺激素(β-hCG)、雌二醇(E_(2))、血清卵泡刺激素(FSH)、黄体生成素(LH)水平较治疗前升高,且观察组β-hCG、E_(2)、FSH、LH水平均高于对照组(P<0.05)。观察组流产和早产发生率分别为16.28%和11.63%,均低于对照组的44.19%和30.23%,足月产发生率为72.09%,高于对照组的25.58%(P<0.05)。结论:子宫动脉阻力增高复发性流产应用地屈孕酮治疗,能改善妊娠结局,效果可靠。

Objective:To investigate the clinical effect of Dydrogesterone in the application of treatment of recurrent abortion with increased uterine artery resistance.Method:From June 2020 to June 2021,86 patients with recurrent abortion with increased uterine artery resistance admitted to Zhangye People’s Hospital Affiliated to Hexi University were selected as research objects.They were randomly divided into control group and observation group,43 cases in each group.The control group was treated with Aspirin,and the observation group was treated with Dydrogesterone.The blood coagulation function indexes,blood flow resistance parameters,sex hormone indexes before and after treatment and pregnancy outcome were compared between the two groups.Result:After treatment,prothrombin time(PT),activated partial thromboplastin time(APTT)and thrombin time(TT)of the two groups were longer than those before treatment,and fibrinogen(FIB)levels were lower than those before treatment,PT,APTT and TT in the observation group were longer than those in the control group,and FIB level was lower than that in the control group(P<0.05).After treatment,the pulsation index(PI),resistance index(RI),ratio of peak systolic velocity to end diastolic velocity(S/D)of umbilical artery in the two groups were lower than those before treatment,PI,RI,S/D in the observation group were lower than those in the control group(P<0.05).After treatment,the levels ofβ-human chorionic gonadotropin(β-hCG),estradiol(E_(2)),serum follicle-stimulating hormone(FSH)and luteinizing hormone(LH)in both groups were increased compared with those before treatment,and the levels ofβ-hCG,E_(2),FSH,LH in the observation group were higher than those in the control group(P<0.05).The incidences of miscarriage and premature delivery in the observation group were 16.28%and 11.63%respectively,which were lower than 44.19%and 30.23%in the control group,and the incidence of full-term delivery in the observation group was 72.09%,which was higher than 25.58%in the control group(P<0.05).Conclusion:Recurrent abortion with increased uterine artery resistance use the Dydrogesterone treatment.It can improve the pregnancy outcome with reliable effect.