临床误诊误治2023,Vol.36Issue(8):84-88,5.DOI:10.3969/j.issn.1002-3429.2023.08.018
IVIG治疗习惯性流产并绒毛膜下血肿效果及对母婴结局的影响
Effect of IVIG on Recurrent Spontaneous Abortion Complicated with Sub-chorionic Hematoma and Its Effect on Maternal and Infant Outcomes
摘要
Abstract
Objective To analyze the effect of intravenous immunoglobulin(IVIG)in the treatment of recurrent spontaneous abortion(RSA)complicated with subchorionic hematoma(SCH)and its effect on maternal and infant outcomes.Methods In total,101 patients with RSA and SCH were selected from March 2020 to March 2021 and divided into IVIG treatment group(n = 53)and control group(n = 48)according to different treatment methods.Immunological indicators[tumor necrosis factor-α(TNF-α),interleukin-10(IL-10),B-lymphocytes,natural killer cells(NK),thyroid peroxidase antibodies,complement 3(C3),complement 4(C4),immunoglobulin A(IgA),IgG,IgM],symptom improvement indica-tors,adverse reactions,and maternal and infant outcomes were analyzed before and after treatment.Results Compared with those before treatment,the levels of B-lymphocytes,NK cells,thyroid peroxidase antibody,IgA,IgG,IgM and TNF-α were significantly decreased in the two groups,while the levels of C3,C4 and IL-10 were significantly increased in IVIG group,and the changes in IVIG group were more significant(P<0.05,P<0.01).The duration of vaginal bleeding,time to symp-tom relief and time to hematoma disappearance in IVIG group were shorter than those in control group(P<0.01).The inci-dence of lower abdominal tingling,menstruation and lower back soreness in IVIG group was significantly lower than that in control group(P<0.05).The success rate of pregnancy in IVIG group was 84.91%(45/53),which was higher than that in control group[64.58%(31/48)](P<0.05).The incidence of premature birth,the mortality rate of premature infants and the hospitalization rate of neonatal intensive care unit in IVIG group were lower than those in control group(P<0.01).Con-clusion IVIG has obvious curative effect on RSA and SCH,which can enhance immunomodulatory function,improve immu-nological index and maternal and infant outcome.关键词
流产,习惯性/绒毛膜下血肿/免疫球蛋白/静脉注射/B淋巴细胞/肿瘤坏死因子-α/药物毒性/母婴结局Key words
Abortion,spontaneous/Subchorionic hematoma/Immunoglobulin/Intravenous injection/B-Lymphocytes/Tumor necrosis factor-α/Drug toxicity/Maternal and infant outcome分类
临床医学引用本文复制引用
李冉,陈荔闽,王燕,高文娟,宋宁,李萌..IVIG治疗习惯性流产并绒毛膜下血肿效果及对母婴结局的影响[J].临床误诊误治,2023,36(8):84-88,5.基金项目
山东省医药卫生科技发展计划项目(202005020213) (202005020213)