黄体酮联合地屈孕酮对黄体功能不足性流产患者激素水平及细胞因子的影响

目的探讨黄体酮联合地屈孕酮对黄体功能不足性流产患者激素水平及细胞因子的影响。方法选取2016年1月—2017年1月某医院收治的黄体功能不足性流产患者80例,根据治疗方法不同分为对照组40例和观察组40例。对照组采用黄体酮治疗,观察组采用黄体酮联合地屈孕酮治疗,评估治疗效果。统计2组出血停止时间、腹痛消失时间及住院时间;统计2组头痛、胃肠道反应、皮疹、乏力、乳房疼痛等不良反应发生情况;检测2组治疗前、后孕酮(P)、雌二醇(E2)和人绒毛膜促性腺激素(hCG)等激素水平;检测2组治疗前、后肿瘤坏死因子-α(TNF-α)、γ干扰素(INF-γ)、白介素4(IL-4)和白介素10(IL-10)等细胞因子水平。结果观察组出血停止时间、腹痛消失时间及住院时间均短于对照组,差异有统计学意义(P<0.05);皮疹、乏力、乳房疼痛等不良反应发生率为20%,与对照组的22.5%比较差异无统计学意义(P>0.05);观察组进行治疗与护理后P、E2和hCG等激素水平均高于对照组,差异有统计学意义(P<0.05);2组治疗后TH1型细胞因子(TNF-α、INF-γ)水平均低于治疗前,TH2型细胞因子(IL-4、IL-10)水平均高于之前,差异有统计学意义(P<0.05),其中观察组进行护理后细胞因子改善情况明显优于对照组,差异有统计学意义(P<0.05)。结论黄体酮联合地屈孕酮治疗黄体功能不足性流产患者,有助于提升治疗效果,改善激素和细胞因子水平,且安全性较好,值得推广应用。

Effect of progesterone combined with dydrogesterone on hormone levels and cytokines in patients with luteal insufficiency abortion

Objective To investigate the effect of progesterone combined with dydrogesterone on the levels of hormones and cytokines in patients with luteal insufficiency abortion. Methods A total of 80 patients with luteal insufficiency abortion treated in our hospital were selectedfrom January 2016 to January 2017.According to the treatment methods, 40 cases were divided into a control group and other 40 cases into an observation group. The control group was treated with progesterone, the observation group was treated with progesterone and dydrogesterone, and the treatment effect was evaluated. The time of bleeding stoppage, abdominal pain disappearance, and hospitalization time were observed and recorded intwo groups; the incidence of adverse reactions, such as headache, gastrointestinal reaction, rash, fatigue, and breast pain were observed and recorded; before and after the treatment, the hormone levels of ketone (P) , estradiol (E2) and human chorionic gonadotropin (hCG) were detected and recorded; before and after treatment, the tumor necrosis factor-alpha (TNF-alpha) , interferon-gamma (INF-γ) , interleukin 4 (IL-4) , and interleukin 10 (IL-10) cytokine levels were also detected and recorded. Results The bleeding stop time, abdominal pain disappearance time and hospitalization time in the observation group were shorter than those in the control group (P<0.05). The incidence of adverse reactions such as headache, gastrointestinal reaction, rash, fatigue, and breast pain in the observation group was 20% and the incidence in the control group was 22.5%, and there was no significant difference (P>0.05). The P, E2 and hCG levels in the observation group were higher than those in the control group after the treatment (P<0.05). In both groups, TH1 levels of cytokines (TNF-α, INF-γ) were lower than those before treatment, and the levels of TH2 cytokines (IL-4, IL-10) were higher than those before the treatment (P<0.05) , and among them, after the treatment, the improvement of cytokines in the observation group was superior to that in the control group. Conclusion Progesterone combined with dydrogesterone in the treatment of patients with luteal insufficiency abortion can help to improve the therapeutic effect, improve the level of hormones and cytokines, and has a good safety. Therefore, it is worthy of popularization and application .