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目的探讨反复自然流产的病因及预防性治疗。方法应用内分泌及免疫学治疗方法对90例反复自然流产(RSA)的病人进行检测及治疗。结果90例RSA患者63例分娩,其中经期子宫内膜活检分泌状态低下者占44.4%。排卵异常占23.8%。尿LH周期异常42.9%。性激素六项异常42.9%。BBT189周期异常36.4%。不孕四项:抗精子抗体(AsAb)、抗子宫内膜抗体(EmAb)、抗心磷脂抗体(AcAb)、抗弓形体抗体(AtAb)的阳性率分别为44.4%、47.6%、0.31%、0.16%。丈夫AsAb阳性率为36.5%。解尿支原体(UU)感染占27%,UU、沙眼衣原体(CT)双感染占0.31%。精液分析活动力和率异常占20.6%。90对夫妻外周血染色体核型分析均正常。已分娩中39人实施免疫治疗。所有的病人孕前及孕时均实行克罗米芬和HCG的预防性治疗,不孕四项一项阳性均用中药抑抗灵治疗。反复清宫致子宫内膜受损月经过少继发不孕者采用补佳乐和安宫黄体酮治疗。结论RSA是多因素,诊疗过程中不可忽视病因学分析和预防性治疗。
Objective To investigate the etiology and preventive treatment of recurrent spontaneous abortion. Methods 90 patients with recurrent spontaneous abortion (RSA) were detected and treated by endocrine and immunological methods. Results 63 cases of RSA were delivered in 90 cases, of which 44.4% were under-secretory endometrial biopsy. Ovulation abnormalities accounted for 23.8%. Urinary LH cycle abnormalities 42.9%. Sex hormones six abnormal 42.9%. BBT189 cycle abnormal 36.4%. Four infertility positive rates of AsAb, EmAb, AcAb and AtAb were 44.4%, 47.6%, 0.31% 0.16%. The positive rate of her husband AsAb was 36.5%. Mycoplasma genitalium (UU) infection accounted for 27%, UU, Chlamydia trachomatis (CT) double infection accounted for 0.31%. Semen analysis of abnormal activity and rate of 20.6%. 90 pairs of couples peripheral blood chromosome karyotype analysis were normal. 39 have given birth in the implementation of immunotherapy. All patients before and during pregnancy are practiced clomiphene citrate and HCG prophylaxis, infertility four are a positive with Chinese medicine anti-Ling treatment. Repeated Qing-induced endometrial damage Menorrhagia secondary infertility use of norepinephrine and progesterone progesterone treatment. Conclusions RSA is a multifactorial factor. Etiology analysis and preventive treatment should not be neglected in the course of diagnosis and treatment.