Journal of Developmental Medicine(Electronic Version)  2021, Vol. 9 Issue (3): 214-219 DOI: 10.3969/j.issn.2095-5340.2021.03.009 |
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| Effects of low molecular weight heparin combined with low dose aspirin on prethrombotic state, liver function and immune function in patients with recurrent abortion |
| Lu Xuejing, Liang Jianmei, Shen Linlin, et al
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Department of Gynecology and Obstetrics, Shijiazhuang Maternal and Child Health Hospital, HeBei, Shijiazhuang 050000,China
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Abstract 【Abstract】 Objective To explore the effects of low molecular weight heparin combined with low
dose aspirin on prethrombotic state, liver function and immune function of patients with recurrent abortion.Methods From January 2018 to June 2019, 108 patients with recurrent abortion in Shijiazhuang Maternaland Child Health Hospital were selected as research objects, and they were divided into the observation group(54 cases) and the control group (54 cases) according to the random number table method. After confirmingthe intrauterine pregnancy, both groups received routine intervention with progesterone injection, progesteronecapsule, folic acid tablets, vitamin E tablets, etc. Both groups were treated with low-dose aspirin tabletsuntil 20 weeks of pregnancy, meanwhile the patients of observation group were treated with low molecular weight heparin calcium injection until 12 weeks of pregnancy. Both groups were followed up to pregnancy.The indexes of prethrombotic state, liver function and immune function were observed before treatment andat 20 weeks of pregnancy, and the pregnancy outcomes and complications were compared between the twogroups. Chi-square test and t test were used for statistical analysis. Results At the 20th week of pregnancy, the plasma antithrombin Ⅲ (AT- Ⅲ ) activity [(107±9)% vs (98±8)%], protein S (PS) activity [(98±13)%vs (91±11)%] and serum transforming growth factor -1 (TGF-1) [(671±98) vs (602±87) μg/L] in observationgroup and control group were higher than those before treatment, and those in observation group were higher than control group (P<0.05). At the 20th week of pregnancy, the level of serum plasminogen activator inhibitor-1
(PAI-1) [(20±4) vs (26±5) μg/L], tissue plasminogen activator (t-PA) [(10.5±0.9) vs (11.1±1.1) μg/L], alanineaminotransferase (ALT) [(17±6) vs (21±7) U/L], albumin (ALB) [(29.1±1.6) vs (32.9±2.2) g/L],
aspartate aminotransferase (AST) [(16.2±2.0) and (18.5±4.7) U/L], interleukin (IL)-17 [(240±44)
vs (281±53) ng/L], interferon-γ [(150±13) vs (161±21) ng/L], IL-6 [(42±14) vs (53±19) μg/L] were
lower than those before treatment, and those in observation group were lower than control group (P<0.05).The success rate of miscarriage prevention in observation group was higher than that in control group [90.7%(49/54) vs 70.4% (38/54)], and so was the rate of full-term birth [75.9% (41/54) vs 57.4% (31/54)] (P<0.05).The fetal survival rate of the observation group and the control group was 13.0% (7/54) vs 14.8% (8/54),and the incidence of complications during pregnancy was 7.4% (4/54) and 14.8% (8/54), respectively, withno significant difference between the two groups (P>0.05). Conclusion Low molecular weight heparincombined with low dose aspirin can effectively improve prethrombotic state, immune function and pregnancyoutcome of patients with recurrent abortion, and will not cause serious damage to liver function.
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Received: 21 January 2020
Published: 27 May 2021
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