黄体酮个体化治疗复发性流产的临床研究

目的本研究旨在根据监测复发性流产孕妇孕早期血清孕酮值，探索黄体酮个体化用量标准及效果，将有助于指导临床中的具体操作，规范用药剂量。方法将108例复发性流产的患者随机分为实验组和对照组，观察对比两组患者治疗至孕12周黄体酮用量、注射天数、保胎成功率。实验组55例，采用个体化治疗方案，根据每周监测孕酮值，及时调整黄体酮用量，当15ng/mL≤孕酮〈20ng／mL，肌注黄体酮针剂60mg／d；当20ng／mL≤孕酮〈25ng／mL，肌注黄体酮针剂40mg／d；当25ng／mL≤孕酮〈30ng／mL，肌注黄体酮针剂20mg／d；当30ng／mL≤孕酮，观察治疗；治疗至孕12周停药。对照组53例，每日肌注黄体酮40mg，至孕12周停药。结果实验组应用黄体酮总量为（1456．23±206．36）mg，注射天数（36．23±6．54）d，对照组应用黄体酮总量为（1827．48±242．05）mg，注射天数（43．54±3．63）d，差异有统计学意义（P〈0．05）；实验组保胎成功率为87．27％，对照组保胎保胎成功率为84．91％，两组的保胎成功率比较，差异无统计学意义（P〉0．05）。结论黄体酮个体化治疗复发性流产可在提高保胎成功率的基础上，减少黄体酮的用量，更适合临床应用。

Clinical research for the individualized treatment of recurrent spontaneous abortion by progesterone

Objective To explore the dosages and effects of progesterone in the individualized treatment of recurrent spontaneous abortion （RSA）by monitoring the level of progestone in the gravidas＇ serum in early pregnancy. This research might be useful to guide the clinical operation and further standardizedthe dosage. Methods 108 RSA women were randomly divided into experimental group and control group. The dosage of progesterone, the number of days receiving injection and the success pregnancy ratewere compared between the two groups from the beginning of the treatment till 12 weeks gestational age. 55patients received individualized treatment, which adjust the dosage of the progesterone by the level of progestonemonitored every week.When 15ng/mL ≤ progestone 〈 20ng/mL inject progesterone 60rag/d; When 20ng/mL ≤ progestone 〈 25ng/mL inject progesterone 40mg/d;When 25ng/mL ≤ progestone 〈 30ng/ mL inject progesterone 20mg/d; When progestone ≥30ng/mL do not inject progesterone and observe. The above mentioned treatment should be continued till 12 weeks gestational age. 53 patients in the control group were under traditional treatment, which means inject progesterone 40rag everyday till 12 weeks gestational age. Results For the experimental groupand control group, the altogether dosage of progesterone were （1456.23 ±206.36）mg and （1827.48 ± 242.05）mg respectively, while the number of days receiving injection is （36.23 ± 6.54 ）days and （3.54 ± 3.63） days, the differences were statistically significant（P 〈 0.05）. The success pregnancy rates were87.27% for the experimental group and 84.91% for the control group, there was no statistical difference（P 〉 0.05）. Conclusion Compared with traditional therapy the individualized treatmentof RSA can cut down the progesterone dosage while guaranteethe success pregnancy rate, which is more suitable for clinical application.