摘要
目的:研究甲氨蝶呤(Methotrexate,MTX)联合米非司酮(Mifepristone,MIF)对异位妊娠患者血液流变学和血清妊娠相关血浆蛋白-A(Pregnancy-associated plasma protein-A,PAPP-A)水平的影响。方法:选取2019年10月至2021年10月我院收治的60例异位妊娠患者为研究对象,采用随机数字表法将患者分为对照组和联合组,每组30例。对照组采用MTX治疗,联合组采用MTX联合MIF治疗。比较两组临床疗效,治疗前、治疗5 d后以免疫法发光法检测血清β-人绒毛膜促性腺激素(β-human Chlorionic Gonadotropin,β-HCG)水平;以腹部彩超检测包块直径及卵巢窦卵泡(Antral follicle count,AFC)数;以免疫法发光法测定血清雌二醇(Estradiol,E2)、卵泡刺激素(Follicle stimulating hormone,FSH)水平;以酶联免疫吸附法测定血清抗苗勒管激素(Anti-mullerian Hormone,AMH)、血管内皮生长因子(Vascular endothelial growth factor,VEGF)、PAPP-A水平;以全自动生化分析仪测定全血高切黏度、全血低切黏度、血浆黏度、以温氏法测定红细胞压积;以放射免疫分析法测定血清抑制素A(Inhibin A,INH-A)、癌抗原125(Carbohydrate antigen 125,CA125)水平。结果:联合组临床总有效率96.67%(29/30)高于对照组73.33%(22/30)(P<0.05);治疗5 d后联合组血清β-HCG水平、包块直径低于对照组,AFC数高于对照组(P<0.05);治疗5 d后联合组E2、FSH水平低于对照组,AMH水平高于对照组(P<0.05);治疗5 d后联合组全血高切黏度、全血低切黏度、血浆黏度、红细胞压积低于对照组(P<0.05);治疗5 d后联合组血清VEGF、INH-A、PAPP-A、CA125水平低于对照组(P<0.05)。结论:MTX联合MIF治疗异位妊娠患者疗效显著,可有效缓解临床症状,改善卵巢储备功能,调节血液流变学,促进病情恢复。
Objective:To investigate the effect of Methotrexate(MTX)combined with Mifepristone(MIF)on hemorheology and serum pregnation-associated plasma protein-A(PAPP-A)levels in ectopic Pregnancy.Methods:A total of 60 patients with ectopic pregnancy admitted to our hospital from October 2019 to October 2021 were selected as research objects.The patients were divided into the control and combination groups by the random number table method,with 30 patients in each group.The control group was treated with MTX,and the combination group was treated with MTX combined with MIF.The clinical efficacy of the two groups was compared.Serum levels ofβ-human chorionic gonadotropin(β-HCG)were detected by immunoluminescence before treatment and 5 days after treatment.The follicle diameter and antral follicle count(AFC)were detected by abdominal color ultrasound.Serum levels of estradiol(E2)and follicle-stimulating hormone(FSH)were measured by immunoluminescence.Serum anti-mullerian hormone(AMH),vascular endothelial growth factor(VEGF),and PAPP-A levels were determined by ELISA.Whole blood high tangential viscosity,whole blood low tangential viscosity,and plasma viscosity were determined by an automatic biochemical analyzer,and hematocrit was determined by the Weinberg method.Inhibin A(INH-A)and cancer antigen 125(CA125)levels in serum were determined by radioimmunoassay.Results:The total effective rate of combination group was higher than that of the control group(P<0.05).After 5 days of treatment,the serumβ-HCG level and mass diameter in the combination group were lower than those in the control group,and the AFC number was higher than that in the control group(P<0.05).The levels of E2 and FSH in the combination group were lower than those in the control group,and the levels of AMH were higher than those in the control group(P<0.05).Whole blood high tangential viscosity,whole blood low tangential viscosity,plasma viscosity and hematocrit in the combination group were lower than those in the control group(P<0.05).The serum levels of VEGF,INH-A,PAPP-A,and CA125 in the combination group were lower than those in the control group(P<0.05).Conclusion:MTX combined with MIF is effective in the treatment of ectopic pregnancy,which can effectively relieve clinical symptoms,improve ovarian reserve function,regulate hemorheology,and promote the recovery of the disease.
作者
李文静
Li Wen-jing(Xinxiang Second People's Hospital,Xinxiang 453000,Henan,China)
出处
《四川生理科学杂志》
2023年第8期1388-1391,共4页
Sichuan Journal of Physiological Sciences
作者简介
李文静,女,主治医师,主要从事妇科肿瘤研究,Email:v9JPTW@163.com。
