中国实用妇科与产科杂志

中国实用妇科与产科杂志

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应用静脉滴注人免疫球蛋白联合抗凝疗法治疗妊娠早期合并抗磷脂综合征临床分析

林琳a，张丹a，王晓彩a，冯小静a，张彦英a，郭帅帅b   

  1. 作者单位：沈阳市妇婴医院a.产科，b.辅助生殖科，辽宁 沈阳 110014
  • 出版日期:2015-04-02 发布日期:2015-04-02

Clinical analysis of intravenous immunoglobulin combined with anticoagulant therapy in the treatment of combination antiphospholipid syndrome in the first trimester of pregnancy.

LIN Lin,ZHANG Dan,WANG Xiao-cai,FENG Xiao-jing,ZHANG Yan-ying,GUO Shuai-shuai.   

  1. Department of Obsterics,Shengyang Women's and Children's Hospital,Shenyang 110014,China
  • Online:2015-04-02 Published:2015-04-02

摘要：

目的 探讨静脉滴注（静滴）人免疫球蛋白联合抗凝疗法治疗妊娠早期合并抗磷脂综合征（APS）临床价值。 方法 回顾性分析2013年5月至2014年10月沈阳市妇婴医院350例有不良孕产史的妇女，排除其他常见原因后，进行抗心磷脂抗体(ACA)、抗β2-糖蛋白1（β2-GP1）抗体测定，再结合其不良孕产史，其中79例患者诊断为抗磷脂综合征（APS），15例APS患者接受单纯口服阿司匹林治疗（Ⅰ组），26例APS患者接受低分子肝素联合阿司匹林治疗（Ⅱ组），38例APS患者接受静滴人免疫球蛋白联合低分子肝素、阿司匹林治疗（Ⅲ组）。 结果 Ⅲ组38例APS患者中有34例妊娠至13周末，4例流产，流产率为10.5%；Ⅱ组18例妊娠至13周末，8例流产，流产率为30.8%；Ⅰ组7例妊娠至13周末，8例流产，流产率高达53.3%。结论 应用静滴人免疫球蛋白联合抗凝疗法治疗妊娠早期合并抗磷脂综合征可明显改善孕早期妊娠结局，为治疗妊娠合并APS的有效方法。

关键词: 抗磷脂综合征, 静滴人免疫球蛋白, 低分子肝素, 阿司匹林

Abstract:

Abstract： Objective To analyze intravenous immunoglobulin combined with anticoagulant therapy in the treatment of combination antiphospholipid syndrome (APS) in the first trimester of pregnancy. Methods Retrospective analysis was done on 350 women with abnormal pregnancy history. After excluding other common reasons, carry out the measurement on anticardiolipin antibody (ACA) and anti β-glycoprotein 1 (β2-GP1) antibody, and then combine with the abnormal pregnancy history.Totally 79 patients were diagnosed with APS; 38 patients with APS accepted intravenous immunoglobulin with low molecular heparin and aspirin therapy; 26 patients with APS accepted low molecular heparin and aspirin therapy; 15 patients with APS was required to take aspirin orally. Results Among 38 patients with intravenous immunoglobulin and anticoagulant therapy, the pregnancy of 34 patients could last to the end of 13 weeks, and four patients suffered abortion, with the abortion rate of 10.5%; among 26 patients with APS with low molecular heparin and aspirin therapy, the pregnancy of 18 patients could last to the end of 13 weeks, and 8 patients suffered from abortion ,with the rate of 30.8%; among 38 patients with APS taking aspirin orally, the pregnancy of 7 patients could last to the end of 13weeks, and 8 patients suffered from abortion, with the abortion rate of 53.3%. Conclusion Immunoglobulin with anticoagulant therapy in the treatment of combination APS in the first trimester of pregnancy can obviously improve the pregnancy outcome of the early pregnancy, and it is regarded as an effective method to cure the pregnancy combination APS.

Key words: antiphospholipid syndrome, intravenous immunoglobulin, low molecular heparin, aspirin

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