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目的探讨原因不明性复发性流产患者给予孕激素治疗、主动免疫治疗及被动免疫治疗等综合治疗后的妊娠结局。方法回顾性分析102例原因不明性复发性流产病例,其中综合治疗组(观察组)52例,孕激素治疗组(对照组)50例。综合治疗组孕前及孕早期给予丈夫淋巴细胞免疫治疗,孕早期给予孕激素及免疫球蛋白治疗;孕激素治疗组孕早期仅给予孕激素。追踪两组患者的妊娠结局。结果给予综合治疗患者妊娠成功率达96.2%(50/52),单纯补充孕激素的患者妊娠成功率为40.0%(20/50),两者差异有统计学意义(χ2=6.37,P=0.012)。观察组妊娠期糖尿病的发生率为16.0%(8/50),对照组为25.0%(5/20),差异无统计学意义(P=0.518)。观察组分娩后新生儿Apgar评分>7分的发生率为98.0%(49/50),对照组为95.0%(19/20),差异无统计学意义(P=0.915)。新生儿男女比例观察组为1.27∶1,对照组为1.22∶1,差异无统计学意义(P=0.857)。结论给予孕激素、主动免疫治疗及被动免疫治疗等综合治疗方法对于URSA患者是安全、有效的。
Objective To investigate the pregnancy outcome of patients with unexplained recurrent spontaneous abortion after progestin therapy, active immunotherapy and passive immunotherapy. Methods A retrospective analysis of 102 cases of unexplained recurrent spontaneous abortion cases, including 52 cases of comprehensive treatment group (observation group), 50 cases of progesterone treatment group (control group). Combined therapy group gave her husband lymphocyte immunotherapy before pregnancy and first trimester, progesterone and immunoglobulin were given in the first trimester, and progestin was only given in the first trimester of pregnancy. Pregnancy outcomes were tracked in both groups. Results The pregnancy rate was 96.2% (50/52) in patients receiving combined therapy and 40.0% (20/50) in pregnant women receiving simple progestin therapy (χ2 = 6.37, P = 0.012) ). The incidence of gestational diabetes mellitus in the observation group was 16.0% (8/50) and that in the control group was 25.0% (5/20), with no significant difference (P = 0.518). The incidence of neonatal Apgar score> 7 after birth in the observation group was 98.0% (49/50), while that in the control group was 95.0% (19/20), with no significant difference (P = 0.915). Neonatal male to female ratio was 1.27: 1 in the observation group and 1.22: 1 in the control group, with no significant difference (P = 0.857). Conclusions The combination therapy of progestin, active immunotherapy and passive immunotherapy is safe and effective for URSA patients.