摘要
目的·研究早期复发性流产(ERSA)患者黄体中期子宫血流参数特征,观察阿司匹林对子宫血液动力学的作用。方法·采用经阴道彩色多普勒超声检测271例有ERSA史妇女(ERSA组)和66例无反复自然流产史妇女(对照组)的黄体中期子宫内膜厚度和子宫血流参数。ERSA组予阿司匹林50 mg/d口服2个月及个体化治疗,观察其对子宫血流参数及再次妊娠的早期妊娠结局的影响。结果·ERSA组黄体中期子宫内膜厚度显著小于对照组,而内膜血流搏动指数(PI)、子宫动脉平均PI(m PI)、平均阻力指数(m RI)和平均收缩期峰值流速/舒张末期流速(m S/D)均显著高于对照组(均P<0.05)。阿司匹林治疗2个月后,ERSA组子宫血流阻力明显改善(P=0.000),且对于子宫内膜厚度<7 mm的患者,用药后子宫内膜厚度增加,差异有统计学意义(P=0.000)。ERSA组中163例完成阿司匹林治疗2个月后的子宫血流参数复测,其中136名患者经个体化治疗后再次妊娠,其中97名患者妊娠≥12周,10名患者于妊娠12周内再次流产,29名患者早期妊娠结局尚无法确定。结论·ERSA患者黄体中期子宫血流阻力较正常育龄妇女显著增加,内膜厚度较薄。阿司匹林可改善ERSA患者的子宫血流灌注,有利于早期妊娠结局的改善。
Objective · To study the hemodynamic parameters of uterine at midluteal phase in patients with early recurrent spontaneous abortion （ERSA） and the effect of aspirin on them. Methods · Transvaginal color Doppler ultrasonography was used to measure the parameters of uterine blood flow and the endometrial thickness at midluteal phase of 271 women with ERSA （ERSA group） and 66 women without a history of recurrent spontaneous abortion （control group）. Then ERSA group were administered with aspirin 50 mg/d orally for 2 months and other individualized treatment, and the effect of aspirin on parameters of uterine blood flow and the early pregnancy outcome of them were observed. Results ~ At midluteal phase, the endometrium was significantly thinner in ERSA group than that in control group. Pulsatility index （PI） of endometrial blood flow and mean PI （mPI）, mean resistance index （mRI）, and mean systolic/diastolic ratio value （mS/D） of uterine arteries were statistically significantly higher in ERSA group in comparison to control group （P〈0.05）. Following aspirin treatment, resistance to uterine blood flow reduced significantly in ERSA group （P=0.000）, and the endometrial thickness increased in the patients with endometfial thickness less than 7 mm （P=0.000）. Only 163 ERSA patients were re-examined by transvaginal color Doppler ultrasonography after aspirin treatment, among whom 136 women was pregnant after individualized treatment. Among these pregnant patients, 97 cases were pregnant for more than or equal to 12 weeks, while 10 cases aborted during the first 12 weeks, and the early pregnancy outcomes of the other 29 cases were still unclear. Conclusion · In comparison with normal fertile women, ERSA patients have significantly higher resistance to uterine blood flow and thinner endometrium. Aspirin can improve uterine blood perfusion, which improves early pregnancy outcome.
出处
《上海交通大学学报（医学版）》
CSCD
北大核心
2017年第4期518-522,共5页
Journal of Shanghai Jiao tong University:Medical Science
关键词
早期复发性流产
阿司匹林
子宫动脉血流
子宫内膜血流
子宫内膜容受性
early recurrent spontaneous abortion
aspirin
uterine artery blood flow
endometrial blood flow
endometrial receptivity
作者简介
王统菲（1992-），女，博士生；电子信箱：tfwang0591@163.com。
[通信作者]赵爱民，电子信箱：zarnzkh0526@126．com。
