李承碧，唐春梅（荣昌区人民医院，重庆462460）

·论著·

不同剂量孕酮针治疗先兆流产临床效果探讨

李承碧，唐春梅△
（荣昌区人民医院，重庆462460）

目的探讨不同剂量孕酮（P）治疗先兆流产的临床效果。方法选取该院2012年1月至2014年12月收治的早孕先兆流产患者126例作为研究对象，采用随机数字表法分为A、B、C三组，每组42例，分别给予肌内注射P针每天20、40、60mg，比较三组患者治疗后血清P、血清β-人绒毛膜促性腺激素（β-HCG）水平，三组患者妊娠至足月例数、不良反应、稽留流产及完全流产发生率。结果A组：P（49.67±9.62）ng/mL、血清β-HCG（5 053.40±90.67）mU/mL；B组：P （50.23±8.24）ng/mL、血清β-HCG（5 052.30±88.43）mU/mL；C组：P（48.54±12.64）ng/mL、血清β-HCG（5 054.50±87.65）mU/mL；三组孕妇治疗后血清P及β-HCG水平比较，差异均无统计学意义（P＞0.05）；三组患者妊娠至足月、不良反应及完全流产发生率比较，差异无统计学意义（P＞0.05）；C组患者的稽留流产发生率均明显高于A、B组，差异均有统计学意义（P＜0.05）。结论先兆流产患者经P安胎治疗后，妊娠结局与P剂量无明显关系，但大剂量P针会使稽留流产发生率增高。

孕酮；流产，先兆；子宫收缩；绒毛膜促性腺激素；妊娠初期

【Abstract】Objective To explore the effect of different doses of progesterone（P）in the treatment of threatened abortion. M ethods A total of 126 cases of early pregnancy threatened abortion in our hospital from January 2012 to December 2014 were selected and divided into the group A，B and C according to the random number table，42 cases in each group.The three groups were intramuscularly injected by 20，40，60mg/d of P.The serum P andβ-HCG levels after treatment were compared among 3 groups.The cases number of full term pregnancy，adverse reactions and the occurrence rates ofmissed abortion and complete abortion were compared too.Results The serum Pandβ-HCG levelswere（49.67±9.62）ng/mLand（5 053.40±90.67）mU/mL for the group A，（50.23±8.24）ng/mL and（5 052.30±88.43）mU/mL for the group B，and（48.54±12.64）ng/mL and（5 054.50±87.65）mU/mL for the group C，the differences among 3 groups were notstatistically significant（P＞0.05）；the cases number of full term pregnancy，occurrence rateofadverse reactionsand complete abortion had no statistical differences among 3 groups（P＞0.05）；the occurrence rate of missed abortion in the group C was significantly higher than thatin the group A and B，the difference was statistically significant（P＜0.05）.Conclusion The pregnancy outcome after Pmiscarriage prevention treatment in the patients with threatened abortion has no obvious relation with Pdose，but large dose of Pcould increase the occurrence rate ofmissed abortion.

【Keywords】Progesterone；Abortion，threatened；Uterine contraction；Chorionic gonadotropin；Pregnancy trimester，first

先兆流产，是指孕周在28周内，孕妇出现腹痛、阴道流血、腰酸等临床症状，若出现在妊娠12周以内，称为早期先兆流产［1-2］；若发生在妊娠12～28周，则称为晚期流产［3-4］。先兆流产发生的原因众多，染色体异常、黄体功能不全、生殖系统疾病、免疫异常、精神因素、环境因素等均可引起先兆流产，其中最为常见的即为黄体功能不全。妊娠妇女在正常情况下卵巢黄体分泌孕酮（P）可以促进子宫内膜由增生期转为分泌期，不仅可以抑制子宫收缩，还可以降低子宫平滑肌敏感性，进而抑制母体对胎儿抗原的免疫应答和对滋养细胞的排斥反应，有利于胚胎的植入。……