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地屈孕酮辅助主动免疫疗法治疗复发性流产的疗效观察

Observation of Efficacy of Dydrogesterone Auxiliary Active Immunotherapy Clinical in Treatment of Recurrent Miscarriage

DOI：

中文关键词: 地屈孕酮主动免疫复发性流产

英文关键词:Dydrogesterone Active immunization Recurrent spontaneous abortion

基金项目:

作者	单位
杨倩	温岭市第一人民医院妇科（浙江温岭 317500）

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中文摘要:

摘要目的:观察屈孕酮辅助主动免疫疗法治疗复发性流产的疗效及安全性。方法：复发性流产患者76例随机分为观察组及对照组各38例。对照组单纯采用主动免疫疗法治疗，观察组实施地屈孕酮辅助主动免疫疗法治疗，比较两组患者孕8周内和孕9～12周孕激素(P)、雌二醇(E2)、绒毛膜促性腺激素(HCG)水平变化，以及保胎成功率、流产率和新生儿畸形率；对比两组胎儿存活者治疗前后血清干扰素（IFN）-γ、白细胞介素（IL）-2、IL 4、IL-6、辅助性T细胞（Th）1/Th2等指标变化和药品不良反应。结果：观察组患者孕9～12周内P、E2、HCG等指标水平均明显高于对照组及本组孕8周时水平(P<0.05)。观察组保胎成功率、流产率、新生儿畸形率等指标均明显优于对照组(P<0.05)。治疗后，观察组IFN-γ、IL-2、Th1/Th2水平均较前明显降低，IL 4、IL-6水平较前明显增高(P<0.05)，而对照组仅IL 4、IL-6水平较前明显增高(P<0.05)；且观察组治疗后IFN-γ、IL-2、Th1/Th2水平均明显低于对照组，IL 4、IL-6水平高于对照组(P<0.05)。两组药品不良反应率比较，差异无统计学意义（P>0.05）。结论：地屈孕酮辅助主动免疫疗法治疗复发性流产有助于提高疗效，安全性好，可降低流产率，提高胎儿存活率，改善患者各项指标，值得临床推广应用。

英文摘要:

ABSTRACT Objective: To observe the curative effect and safety of dydrogesterone auxiliary active immunotherapy in treatment of recurrent miscarriage. Methods:76 cases of patients with recurrent spontaneous abortion were randomly divided into observation group and control group, each had 38 cases. Control group were treated with active immunotherapy treatment, observation group given dydrogestrone auxiliary active immunotherapy treatment, compared the progestational hormone(P), estradiol(E2), human chorionic gonadotropin(HCG) of the patients with 8 weeks and 9-12 weeks of gestation in two groups, and the success rate of miscarriage, abortion rates and birth defects rate.Also,the IFN-γ, IL-2，IL 4，IL-6，Th1, Th2, Th1/Th2 levels of survival fetus before and after treatmentand the adverse drug reaction would be compared.Results:The P, E2, HCG levels of pregnant patients with 9-12 weeks in the observation group were significantly higher than the control group and the same group of patients at 8 weeks (P<0.05). The success rate of miscarriage, abortion rates, and birth defects rates of the observation group were significantly better than the control group (P<0.05). After the treatment, the IFN-γ, IL-2, Th1/Th2 levels of obervation group were significantly lower than before, while the IL-4, IL-6 levels were significantly higher than before (P<0.05), for the control group, only IL-4, IL-6 levels were significantly higher than before (P<0.05).Compared the two groups, the IFN-γ, IL-2, Th1/Th2 levels of observation group after treatment were significantly lower than the control group, IL-4, IL-6 levels much higher than the control group (P<0.05). There was no statistically significant difference between the two groups about the adverse drug reaction rate (P>0.05). Conclusion:The dydrogesterone auxiliary active immunotherapy in treatment of recurrent miscarriage had good safety, it could enhance the curative effect, reduce the abortion rate, improve fetal survival rate, improve patient indicators, it was worth clinical promoting.

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