低分子肝素治疗ART妊娠后复发性流产的效果及对激素水平、凝血功能的影响

Effect of low molecular weight heparin for treating pregnant women with recurrent abortion after ART and its influence on hormone levels and pregnancy outcomes of women

目的:分析低分子肝素治疗人类辅助生殖技术(ART)获得妊娠后复发性流产效果及对激素、凝血功能的影响。方法:选取本院2013年1月—2017年12月收治的接受ART后有先兆流产的早孕复发性流产患者120例,根据治疗方法不同分为对照组和观察组。对照组采用常规治疗,观察组采用常规治疗+低分子肝素治疗,观察两组治疗临床效果。结果:治疗前,两组绒毛膜促性腺激素(HCG)、孕酮(P)、雌二醇(E_2)、D-二聚体(D-D)、纤溶酶原激活物抑制物1(PAI-1)、纤维蛋白原水平比较无差异(P>0.05)。治疗后,观察组HCG、P、E_2水平高于对照组,D-D、PAI-1、纤维蛋白原水平低于对照组(P<0.05)。观察组足月生产率高于对照组、流产率低于对照组(P<0.05),早产率与对照组比较无差异(P>0.05)。两组血小板减少、牙龈出血、瘀斑、胃肠道反应等发生率比较无差异(P>0.05)。结论:低分子肝素治疗ART获得妊娠后复发性流产,可改善患者激素水平和高凝状态,提高足月生产率,降低流产率,且安全性较好。

Objective:to analyze the effect of low molecular weight heparin(LMWH)for treating pregnant women with recurrent abortion after human assisted reproductive technique(ART)ART and its influence on hormone levels and pregnancy outcomes of women.Methods:From January 2013 to December 2017,120 early pregnant women with recurrent abortion who received ART were selected and divided into control group and observation group according to different treatment methods.The women in control group were treated by routine therapy,and the women in observation group were treated by low molecular weight heparin except to routine therapy.The therapy efficacy of women in both groups was analyzed.Results:Before treatment,there were no significant different in the levels of human chorionic gonadotropin(HCG),progesterone(P),estradiol(E2),D-dimer(D-D),fibrin enzyme activators inhibitor 1(PAI-1),and fibrinogen of women between the two groups(P>0.05).After treatment,the levels of HCG,P,and E2 of women in observation group were significant higher than those of women in control group(P<0.05),but the levels of D-D,PAI-1,and fibrinogen were significant lower than those of women in control group(P<0.05).The rate of full-term pregnancy of women in observation group was significant higher than those of women in control group(P<0.05),but abortion rate was significant lower than that of women in control group(P<0.05).The rate of premature delivery,and incidences of thrombocytopenia,gingival hemorrhage,and ecchymosis and gastrointestinal reaction had no significant different between the two groups(P>0.05).Conclusion:LMWH used for treating pregnant women with recurrent abortion after ART can improve the rate of full-term pregnancy and reduce abortion rate,and has high safety.