单次注射甲氨蝶呤治疗输卵管妊娠的临床疗效及对血清β-人绒毛膜促性腺激素、胎盘生长因子、血管内皮生长因子的影响OA
Clinical Efficacy of Single Injection of Methotrexate in the Treatment of Tubal Pregnancy and its Effect on Serum β-Human Chorionic Gonadotropin,Placental Growth Factor and Vascular Endothelial Growth Factor
目的:探讨单次注射甲氨蝶呤治疗输卵管妊娠的临床疗效及对其血清β-人绒毛膜促性腺激素(β-HCG)、胎盘生长因子(PLGF)、血管内皮生长因子(VEGF)的影响.方法:选取2019年6月～2021年6月某院收治的80例输卵管妊娠患者作为研究对象,按照随机数字表法及患者充分知情自愿原则分为对照组和观察组,每组40例.所有患者入院后均卧床静养,严密监测生命体征变化.对照组患者常规采用分次注射甲氨蝶呤方案,观察组患者采用单次注射甲氨蝶呤方案.比较两组患者临床疗效、临床症状(腹痛、阴道出血、盆腔包块)改善、血清β-HCG恢复正常及患者住院时间、血液指标(β-HCG、孕酮、PLGF、VEGF)、盆腔包块直径、不良反应发生情况及治疗后生育情况.结果:治疗后,观察组患者治疗总有效率(90.00%)高于对照组(72.50%,P<0.05);观察组患者临床症状改善时间、血清β-HCG恢复正常时间均短于对照组(P<0.05);两组患者住院时间比较无统计学差异(P>0.05);两组患者血清β-HCG、PLGF、VEGF、孕酮水平及盆腔包块直径均降低(P<0.05),且观察组低于对照组(P<0.05);观察组患者不良反应总发生率(17.50%)低于对照组(37.50%,P<0.05);两组患者宫内妊娠率比较无统计学差异(χ2=0.503,P=0.478).结论:单次注射甲氨蝶呤的给药方式治疗输卵管妊娠临床疗效确切,可有效改善患者的临床症状,降低患者血清β-HCG、PLGF、VEGF水平,且未增加不良反应的发生风险.
Objective:To investigate the clinical efficacy of single injection of methotrexate in the treatment of tubal pregnancy and its effect on serum β-human chorionic gonadotropin(β-HCG),placental growth factor(PLGF)and vascular endothelial growth factor(VEGF).Methods:A total of 80 patients with tubal pregnancy who were treated in a certain hospital from June 2019 to June 2021 were divided into the control group and the observation group according to the random number table method and the patients'fully informed consent and voluntary basis,with 40 patients in each group.All patients were in bed rest upon admission and closely monitored for changes in vital signs.The control group was treated with conventional fractional injections of methotrexate and the observation group was treated with single injection of methotrexate.The clinical efficacy,improvement time of clinical symptoms(abdominal pain,vaginal bleeding and pelvic mass),time for serum β-HCG returning to normal,length of hospital stay,hematological markers(β-HCG,progesterone,PLGF,VEGF),diameter of pelvic mass,adverse reactions and post-treatment fertility were compared between the two groups.Results:After treatment,the total response rate in the observation group(90.00%)was higher than that in the control group(72.50%,P<0.05).The time of improvement in clinical symptoms and the recovery time of serum β-HCG in the observation group were shorter than those in the control group(P<0.05).There was no statistically significant difference in the length of hospital stay between the two groups(P>0.05).Serum levels of β-HCG,PLGF,VEGF,progesterone and pelvic mass diameter were decreased in two groups(P<0.05),and observation group was lower than control group(P<0.05).The total incidence of adverse reactions in the observation group(17.50%)was lower than that in the control group(37.50%,P<0.05).There was no statistically significant difference in the intrauterine pregnancy rate between the two groups(χ2=0.503,P=0.478).Conclusion:The single injection of methotrexate in the treatment of tubal pregnancy showed definite clinical efficacy as demonstrated by effectively improved clinical symptoms,reduced serum levels of β-HCG,PLGF and VEGF,without additional risks of adverse reactions.
刘志平;张慧;唐小珂
新郑市公立人民医院妇产科,郑州 451100郑州大学附属郑州中心医院妇科,郑州 450000
临床医学
甲氨蝶呤输卵管妊娠β-人绒毛膜促性腺激素胎盘生长因子血管内皮生长因子
methotrexatetubal pregnancyβ-human chorionic gonadotropinplacental growth factorvascular endothelial growth factor
《中国合理用药探索》 2024 (004)
12-17 / 6
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