静脉用免疫球蛋白联合补肾化瘀汤治疗原因不明复发性自然流产的疗效及对血栓前状态和外.docVIP

静脉用免疫球蛋白联合补肾化瘀汤治疗 原因不明复发性自然流产的疗效及对血 栓前状态和外周血Thl7/Treg免疫失衡 的影响 张晓姗 陕西省人民医院 目的观察静脉用免疫球蛋白（TVTG）联合补肾化瘀汤治疗原因不明复发性自然 流产（URSA）的疗效及对血栓前状态（PTS）和外周血Thl7/Treg免疫失衡的影 响。方法将100例URSA患荠随机分为观察组50例和对照组50例，对照组给予 1V1G治疗，并追踪至妊娠结束，观察组在对照组基础上补肾化瘀汤治疗。观察2 组治疗前后血绒毛膜促性腺激素（HCG）、孕酮、PTS及外周血Thl7/Treg细胞 因子的变化情况，记录2组临床妊娠结局。结果2组治疗后血清HCG、孕酮水平、 抗凝血酶III （AT-III）及白细胞介素-10 （IL-10）、转化生长因子-P 1 （TGF-P1） 水平均显著升高，血清D-二聚体（D-D）、组织型纤溶酶原激活物（tPA）、纤 溶酶原激活抑制剂-1 （PA1-1）、1L-17、1L-6水平均显著降低，且观察组各指 标改善情况均优于对照组（P均0.05）:观察组妊娠结局中活产率高于对照组 （P〈0.05）,未活产率低于对照组（P0. 05） ;2组治疗期间无药物不良反应情况 发生。结论IVIG联合补肾化瘀汤治疗URSA疗效确定，可显著提高安胎成功率, 改善临床结局，且作用安全，其机制可能与抑制机体PTS、促进外周血 Thl7/Treg免疫平衡有关。 关键词： 静脉用免疫球蛋白;补肾化瘀汤;原因不明复发性自然流产;血栓前状态; Thl7细胞;调节性T细胞; 张晓姗，女，主治医师，研宄方向为产科并发症及合并症的处理。 2016-12-25 Effects of intravenous immunoglobulin combined with decoction for tonifying kidney and resoling stasis on unexplained recurrent spontaneous abortion and on prethrombus and peripheral blood Thl7/Treg immune imbalance ZHANG Xiaoshan The People’s Hosptial of Shaanxi Province; Abstract： Objective It is to observe the effect of intravenous immunoglobulin (IVIG) combined with decoction for tonifying kidney and resoling stasis on unexplained recurrent spontaneous abortion (URSA) and on prethrombotic state (PTS) and peripheral blood Thl7/Treg immune imbalance. Methods 100 patients with URSA were randomly divided into observation group and control group，50 cases in each group. The control group was treated with IVIG, and was tracked until the end of pregnancy, the observation group was treated with decoction for tonifying kidney and resoling stasis on the basis of therapy in the control group. The changes of HCG, progesterone, PTS and peripheral blood Thl7/Treg cytokines before and after treatment were observed in both groups, and clinical pregnancy outcomes were recorded.Results After treatment the levels of serum HCG, progesterone, anti thrombin Ill (AT-I11) and IL-10, transforming growth factor 3 1 (TGF- 3 1) were significantly increased, while that of serum D-dimer (D