早期抗凝干预治疗对冻融胚胎移植前高D-二聚体患者妊娠结局的影响

目的:探讨冻融胚胎移植(FET)前高D-二聚体患者的早期抗凝干预治疗对妊娠结局的影响。方法:选取2016年10月—2017年10于贵州医科大学附属医院生殖中心进行FET的不孕患者89例,检测FET前一日D-二聚体水平,选取浓度>0.5μg/mL的患者,并随机分为干预组(43例)和对照组(46例),干预组予小剂量阿司匹林或低分子肝素钠治疗,对照组未行抗凝干预治疗。比较2组D-二聚体水平及着床率、临床妊娠率、早期流产率的差别。结果:2组间D-二聚体浓度、着床率和临床妊娠率比较差异无统计学意义(P>0.05),而干预组的流产率低于对照组,差异有统计学意义(P<0.05)。结论:FET前对高D-二聚体的患者予低分子肝素或小剂量阿司匹林行早期抗凝干预治疗,可能改善患者的妊娠结局。

Effect of Early Anticoagulation Intervention on Pregnancy Outcome in Patients with High D-dimer before Freezing Embryo Transfer

Objective：To analyze the effect of early anticoagulation intervention on pregnancy outcome in patients with high D-dimer before freezing embryo transfer (FET). Methods：A total of 89 patients undergoing FET were included in the present study. The level of D-dimer on the day before FET was measured. Those patients with high D-dimer (more than 0.5 μg/mL) were randomly divided into two groups: the treatment group (43 patients) and the control group (46 patients). Patients in the treatment group were treated with low-dose aspirin or low-molecular-weight heparin sodium, while patients in the control group were not treated. The D-dimer level, implantation rate, clinical pregnancy rate and early abortion rate were compared between the two groups. Results：There were no significant differences in D-dimer concentration, implantation rate and clinical pregnancy rate between the two groups (P＞0.05). However, the abortion rate in the treatment group was significantly lower than that in the control group (P＜0.05). Conclusions：Early anticoagulation therapy with low dose aspirin or low molecular weight heparin in those patients with the high level of D-dimer before FET can improve the pregnancy outcome.