诊治血栓前状态相关复发性流产的中西医研究进展

许多学者认为血栓前状态(Prethrombotic State,PTS)与复发性流产(Recurrent Spontaneous Abortion,RSA)的发生密切相关,具体病理机制尚不明确。临床上患者常无特殊症状,仅提示相关实验室指标的异常。血栓前状态标志物临床较多采用血小板聚集率、凝血-纤溶标志物和子宫动脉血流等,目前尚无统一诊断标准。西医治疗以抗凝治疗为主,包括低分子肝素、小剂量阿司匹林,但同时不良反应的发生较多,且存在未知风险。中医认为该病以“肾虚血瘀”为主要病机,辨证施治以活血化瘀、健脾益气、补肾疏肝为主。本文对血栓前状态相关复发性流产的实验室指标及临床治疗进展进行概述。

Research Progress in Diagnosis and Treatment of Prethrombotic Status Related Recurrent Abortion

Many scholars believe that prethrombotic state is closely related to recurrent spontaneous abortion and the specific pathological mechanism is not yet clear.Clinical patients often have no special symptoms and only indicate abnormalities of laboratory indicators related to PTS.The prethrombotic status markers cover platelet aggregation rate,thrombo-fibrinolytic markers and uterine artery blood flow in clinical practice.There is no unified diagnostic standard.Western medicine treatment is mainly anticoagulant therapy,including low molecular weight Heparin,low dose aspirin.At the same time,there are more adverse reactions and unknown risks.In traditional Chinese medicine,the disease is dominated by“Kidney deficiency and Blood stasis”,and the syndrome treatment is mainly to supplement the Kidney,strengthen the Spleen,and move Blood circulation.In this paper,the laboratory indexes and clinical treatment progress of prethrombotic state related recurrent abortion are summarized.