阿司匹林联合泼尼松治疗复发性流产效果观察

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1、412JBengbuMedColl，April2013，Vol．38，No．4［文章编号］1000-2200(2013)04-0412-03·临床医学·阿司匹林联合泼尼松治疗复发性流产效果观察张静，张宁芝［摘要］目的:观察小剂量阿司匹林联合泼尼松治疗复发性流产(RSA)的疗效。方法:将53例RSA的患者随机分为治疗组33例和对照组20例。治疗组每天予以阿司匹林100mg、泼尼松5mg1次口服，共3个月;3个月后阿司匹林减量至25mg，泼尼松减量至2．5mg，每晚1次口服，直至妊娠后3个月。对照组常规黄体酮等保胎药物治疗。将生育活婴或者妊娠28周内未出现胎儿异常视为妊娠有效，比

2、较2组治疗有效率、活产率及妊娠合并症发生率。结果:治疗组患者治疗有效率明显高于对照组(P＜0．01)，且妊娠期使用小剂量阿司匹林及泼尼松并不增加妊娠合并症的发生。结论:小剂量阿司匹林联合泼尼松能有效改善RSA的妊娠结局，具有临床可行性。［关键词］复发性流产;阿司匹林;泼尼松;黄体酮［中国图书资料分类法分类号］R714．12［文献标志码］AAspirincombinedwithprednisonefortreatmentofrecurrentspontaneousabortionZHANGJing，ZHANGNing-zhi(DepartmentofObstetricsandG

3、ynecology，FuyangPeople'sHospital，FuyangAnhui236000，China)［Abstract］Objective:Toinvestigatetheefficacyoflowdoseofprednisonecombinedwithaspirinonrecurrentspontaneousabortion(RSA)．Methods:Fifty-threecasesofRSAwererandomlydividedintotreatmentgroup(33cases)andcontrolgroup(20cases)．Thecasesinthet

4、reatmentgroupwereadministeredlowdoseofprednisone100mgonceeachdayandaspirin5mgonceeverynightfor3months;3monthslater，thedosageofaspirinwasdecreasedto25mgandprednisoneto2．5mgonceeverynight．Thetherapywascarriedoutuntil3monthsafterpregnancy;thecontrolsweregiventheroutinetherapyofprogesteroneonly

5、．Thetherapywasregardedaseffectivewhenthefetalinuterowasaliveorpresentingnofetaldisorderat28weeksofgestation．Thetreatmentefficacy，thelivebirthrateandtheincidenceofpregnancy-coexisteddiseaseswerecomparedbetweenthetwogroups．Results:Theefficacyrateinthetreatmentgroupwassignificantlyhigherthanth

6、atinthecontrol(P＜0．01)andlowdoseofaspirinandprednisonewouldnotincreasetheincidenceofpregnancy-coexisteddiseases．Conclusions:ThetherapyoflowdoseofprednisonecombinedwithaspirincaneffectivelypreventtheincidenceofRSAandishighlyfeasibleinclinicalapplication．［Keywords］recurrentspontaneousabortion

7、;aspirin;prednisone;progesterone妊娠不足28周，或胎儿体重不足1000g而终殖医学领域亟待解决的问题。本研究对RSA患者止妊娠者称为复发性流产(recurrentspontaneous采用小剂量阿司匹林联合泼尼松的方案治疗，临床abortion，RSA);而连续自然流产2次或者2次以上效果较为满意，现作报道。称为复发性流产，是育龄期妇女的常见病，其发生率1资料与方法［1］约为5%。临床上常见的四大原因包括染色体异常、子宫畸形、内分泌异常及生殖道感染。免疫因素1．1一般资料