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目的:探讨静脉注射丙种球蛋白(IVIG)治疗抗磷脂综合征(APS)所致复发性流产的临床疗效,比较IVIG与传统治疗及阿司匹林+强的松+潘生丁治疗APS所致复发性流产的疗效差异。方法:248例APS所致复发性流产患者,随机分为4组;组1:传统保胎治疗(54例,黄体酮+HCG等);组2:阿司匹林+强的松+潘生丁(84例);组3:IVIG(38例);组4:阿司匹林+强的松+潘生丁联合IVIG(72例)。观察疗效、妊娠结局、不良反应及妊娠并发症。结果:IVIG组(79.76%)与阿司匹林+强的松+潘生丁组(73.68%)妊娠成功率相比,差异无显著性(P>0.05),此二组与传统保胎治疗组(18.52%)妊娠成功率相比,差异有显著性(P<0.05)。联合用药组(95.83%)妊娠成功率与其它三组相比,差异有显著性(P<0.05)。任意两组妊娠并发症无显著差异(P>0.05)。结论:阿司匹林+强的松+潘生丁联合IVIG治疗APS所致复发性流产,妊娠成功率较高,并发症无明显增加。
Objective: To investigate the clinical efficacy of intravenous gamma globulin (IVIG) in the treatment of recurrent spontaneous abortion caused by antiphospholipid syndrome (APS), and to compare the efficacy of IVIG with conventional treatment and aspirin + prednisone + dipyridamole in the treatment of recurrent spontaneous abortion difference. Methods: 248 patients with recurrent spontaneous abortion due to APS were randomly divided into 4 groups. Group 1: Traditional tocolytic treatment (54 cases, progesterone plus HCG, etc.); Group 2: Aspirin + prednisone plus dipyridamole (84 cases) ; Group 3: IVIG (38 cases); Group 4: Aspirin + Prednisone + Dipyridamole in combination with IVIG (72 cases). Observation of efficacy, pregnancy outcome, adverse reactions and pregnancy complications. Results: The success rate of pregnancy in IVIG group (79.76%) was not significantly different from that in aspirin + prednisone + dipyridamole group (73.68%) (P> 0.05) The success rate of pregnancy compared to the difference was significant (P <0.05). The success rate of pregnancy in combination group (95.83%) was significantly higher than that in the other three groups (P <0.05). No significant difference in any two pregnancy complications (P> 0.05). Conclusion: Aspirin + prednisone + dipyridamole combined with IVIG in the treatment of recurrent spontaneous abortion caused by APS has a high success rate of pregnancy and no significant increase of complications.