阿司匹林单独用药或联合低相对分子质量肝素治疗血栓前状态下复发性流产患者的对比研究

摘要

Objective To explore the analysis of aspirin (ASA)alone or ASA combined with low molecular weight heparin (LMWM)treatment of thrombosis condition before the clinical curative effect of patients with recurrent miscarriage.Methods Select our hospital from January 2014 to January 2014 admitted during the period of the thrombus state to 58 patients with recurrent miscarriage before,as a clinical study.Randomly divided into two groups,each group 29 cases,control group were treated by ASA monotherapy,experimental group were treated by ASA with LMWM therapy.Compare two groups of patients before and after treatment the body serum human chorionic gonadotropin (HCG) and progesterone (P),estradiol (E2),and other hormone levels,as well as the original tissue fibrinolytic enzyme activators (t-PA),fibrinolytic enzyme activators inhibitor 1 (PAI 1),D-dimer (D-D),thrombin time (TT) and blood coagulation function index changes.Results The index comparison between groups before treatment,there was no statistically significant difference(P ＞ 0.05),after treatment,groups of patients with HCG,P and E2 levels were significantly elevated,the experimental group HCG,P and E2 levels were significantly higher than the control group (P ＜0.05).Compared with before treatment,two groups of patients,PAI-1 D-D level were significantly decreased,and the experimental group,PAI-1 D-D level significantly lower than the control group (P ＜ 0.05),each group patients t-PA and TT index was obviously on the high side,the t-PA and TT indicators and test group than the control group increased significantly(P ＜ 0.05),with significant statistical significance difference between the groups.Conclusion ASA with LMWM therapy before thrombus state recurrent miscarriage curative effect is distinct,can obviously improve the patient's level of estrogen,effectively relieve clots before state,to a certain extent,improve live birth rates.%目的 探究阿司匹林(ASA)单独用药或阿司匹林联合低相对分子质量肝素(LMWH)治疗血栓前状态下复发性流产患者的临床疗效.方法 选取我院自2014年1月～ 2016年1月期间收治的血栓前状态致复发性流产患者58例,作为临床研究对象.随机分为两组,每组各29例,对照组患者采用ASA单药治疗,试验组患者采用ASA联合LMWH治疗.比较两组患者治疗前后机体血清绒毛膜促性腺激素(HCG)、孕酮(P)、雌二醇(E2)等激素水平以及组织型纤溶酶原激活物(t-PA)、纤溶酶原激活物抑制物1(PAI-1)、D二聚休(D-D)、凝血酶时间(TT)等指标的变化.结果 治疗前组间各指标比较,差异无统计学意义(P＞0.05),治疗后,各组患者HCG、P、E2激素水平均明显升高,试验组HCG、P、E2激素水平均较对照组明显偏高(P＜0.05).与治疗前相比,两组患者PAI-1、D-D水平均明显下降,且试验组PAI-1、D-D水平明显低于对照组(P＜0.05),各组患者t-PA及TT指标均较治疗前明显偏高,且试验组t-PA及TT指标较对照组升高明显(P＜0.05),组间差异具有显著统计学意义.结论 ASA联合LMWH治疗血栓前状态下复发性流产疗效显著,可明显改善患者的雌性激素水平,有效缓解血栓前状态,在一定程度上提高活产率.