中国临床药理学杂志2026，Vol.42Issue(14)：1978-1984,7.DOI:10.13699/j.cnki.1001-6821.2026.14.005
依诺肝素钠治疗妊娠早期绒毛膜下血肿患者的临床研究
Clinical trial of enoxaparin sodium in the treatment of patients with subchorionic hematoma in early pregnancy
摘要
Abstract
Objective To investigate the clinical efficaly and safety of enoxaparin sodium injection in the treatment of patients with subchorionic hematoma(SCH)in early pregnancy.Methods Patients with SCH in early pregnancy were divided into treatment group A,treatment group B and control group using random number table.The control group received dydrogesterone tablets(oral,10 mg twice daily,continued until ultrasound confirmed complete resolution of the subchorionic hematoma,at which point treatment was discontinued),while the treatment group received dydrogesterone tablets plus enoxaparin sodium injection(dydrogesterone tablets,10 mg orally twice daily,plus enoxaparin sodium injection,4 000 AxaIU subcutaneously once daily).In group A,after uterine arterial blood flow returned to normal,subcutaneous enoxaparin sodium injection was discontinued,while dydrogesterone tablets were continued orally until the subchorionic hematoma resolved,at which point treatment was discontinued.In group B,all medication was discontinued after the subchorionic hematoma resolved.Both groups received treatment for 12 weeks and were followed up until delivery.We compared clinical efficacy,hematoma resolution,uterine arterial blood flow parameters[resistance index(RI),pulsatility index(PI),systolic peak flow velocity to end-diastolic flow velocity ratio(S/D)],and hormone levels[estradiol(E2),progesterone(P),β-human chorionic gonadotropin(β-hCG)];placental growth factor/soluble fms-like tyrosine kinase-1,placental growth factors[placental growth factor(PLGF),soluble fms-like tyrosine kinase-1/PLGF(sFlt-1/PLGF)];and pregnancy outcomes,and safety analysis was conducted.Results A total of 128 pregnant women with SCH were enrolled in this study,including 64 in the treatment group(32 in group A and 32 in group B)and 64 in the control group.After 36 weeks of treatment,the PLGF levels in treatment group A and treatment group B were(280.16±73.00)and(270.60±70.27)pg·mL-1,respectively,both higher than that in the control group's(215.32±68.46)pg·mL-1.The sFlt-1/PLGF ratios after 36 weeks of treatment were 20.84±4.44 for treatment group A and 21.19±5.26 for treatment group B,both lower than that in the control group's 25.58±5.67.All the above differences were statistically significant(all P＜0.05).The incidence of adverse pregnancy outcomes was 12.50％(4 cases/32 cases)in group A and 15.63％(5 cases/32 cases)in group B,both statistically significantly lower than the 35.94％(23 cases/64 cases)in the control group(all P＜0.05).However,there was no statistically significant difference between group A and group B regarding these indicators(P＞0.05).During treatment and follow-up,no serious adverse reactions(≥grade 3)occurred among patients in any group,and the occurrence rates of adverse events across groups did not differ significantly(P＞0.05).Conclusion Enoxaparin sodium injection significantly improves uteroplacental blood flow perfusion in patients with early pregnancy subchorionic hematoma,accelerates hematoma absorption,promotes hormone secretion and placental functional reserve,thereby achieving superior pregnancy outcomes.关键词
依诺肝素钠注射液/绒毛膜下血肿/妊娠早期/子宫动脉血流/妊娠结局Key words
enoxaparin sodium injection/subchorionic hematoma/early pregnancy/uterine artery blood flow/pregnancy outcome分类
医药卫生引用本文复制引用
周凌娟,王慧芝,沈秋莉,刘菲,方杭霞,唐婧..依诺肝素钠治疗妊娠早期绒毛膜下血肿患者的临床研究[J].中国临床药理学杂志,2026,42(14):1978-1984,7.基金项目
2024年度杭州市农业与社会发展领域基金资助项目(20241029Y154) （20241029Y154）
