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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。
Objective: To observe the efficacy and safety of dorsprone-assisted active immunotherapy in the treatment of recurrent spontaneous abortion. Methods: 76 cases of recurrent spontaneous abortion were randomly divided into observation group and control group, 38 cases each. The control group was treated with active immunotherapy alone. The observation group was treated with dydrogesterone-assisted active immunotherapy. The levels of progesterone (P), estradiol (E2), villi (HCG) levels, and the success rate of miscarriage, miscarriage rate and neonatal malformation rate were compared between the two groups before and after treatment. The levels of IFN-γ, IL-2, IL-4, IL-6, T helper 1 / Th2 and other adverse drug reactions. Results: The levels of P, E2 and HCG in observation group were significantly higher than those in control group and 8 weeks pregnant group (P <0.05). The observation group miscarriage success rate, abortion rate, neonatal malformation rate and other indicators were significantly better than the control group (P <0.05). After treatment, the levels of IFN-γ, IL-2 and Th1 / Th2 in the observation group were significantly lower than those in the former group and the levels of IL-4 and IL-6 in the observation group were significantly increased (P <0.05). The levels of IFN-γ, IL-2 and Th1 / Th2 in the observation group were significantly lower than those in the control group, and the levels of IL-4 and IL-6 in the observation group were higher than those in the control group P <0.05). Two groups of adverse drug reaction rates, the difference was not statistically significant (P> 0.05). Conclusion: Dydrogesterone-assisted active immunotherapy for recurrent spontaneous abortion can improve the curative effect and safety, reduce the abortion rate, improve fetal survival rate and improve the indexes of patients. It is worthy of clinical application.