标题：低分子肝素联合小剂量阿司匹林治疗ACA阳性复发性流产临床疗效分析

      作者：唐 洪，黄妙云，谭 毅
    （桂东县人民医院妇产科，广西 梧州 543001）

      卷次： 2012年23卷23期

      【摘要】 目的 探讨低分子肝素联合小剂量阿司匹林治疗抗心磷脂抗体(ACA)阳性复发性流产的临床疗效
及安全性分析。方法 将86例ACA阳性、有反复流产史的早孕孕妇随机分成对照组与观察组，42例对照组患
者给予小剂量阿司匹林联合强的松治疗，44例观察组患者给予低分子肝素联合小剂量阿司匹林治疗。比较两
组孕妇妊娠结局、抗体清除率、不良反应发生率、血小板数（PLT）及活化部分凝血活酶时间（APTT）。结果 观察
组活产率及抗体清除率分别为90.9%和72.7%，显著高于对照组的73.8%和31.0%(P<0.05)；观察组与对照组分娩
出血量、血小板减少、瘀斑及胃肠道反应发生率差异均无统计学意义(P>0.05)；治疗后两组APTT和PLT值差异无
统计学意义(P>0.05)。结论 低分子肝素联合小剂量阿司匹林可改善ACA阳性复发性流产妊娠结局，且不增加
不良反应。

      【关键词】 反复性流产；低分子肝素；阿司匹林

      【中图分类号】 R714.21 【文献标识码】 A 【文章编号】 1003—6350（2012）23—013—02<

br>Effect of low molecular weight heparin combined with low-dose aspirin for ACA positive recurrent
spontaneous abortion.
TANG Hong, HUANG Miao-yun, TAN Yi. Department of Obstetrics and Gynecology, People's
Hospital of Guidong County, Wuzhou 543001, Guangxi, CHINA

【Abstract】 Objective To explore the clinical effect of low molecular weight heparin combined with
low-dose aspirin for ACA positive recurrent spontaneous abortion. Methods Eighty-six early pregnant women with
ACA positive recurrent spontaneous abortion were randomly divided into the control group and the study group. Pa-
tients in the control group (n=42) were given low-dose aspirin combined with prednisone for treatment, while those in
the study group (n=44) received low molecular weight heparin combined with low-dose aspirin for treatment. The
pregnancy outcome, antibody clearance rate, incidence of adverse reactions, PLT and APTT were compared between
the two groups. Results The live birth rate and antibody clearance rate were 90.9% and 72.7% in the study group, re-
spectively, which were significantly higher than those in the control group (73.8% and 31.0%,P<0.05). There was no
statistically significant difference in postpartum blood loss, thrombocytopenia, ecchymosis, the incidence of gastro in-
testine reaction, PLT and APTT between two groups (P>0.05). Conclusion For ACA positive recurrent spontaneous
abortion, low molecular weight heparin combined with low-dose aspirin can improve the pregnancy outcome and do
not result in more side-effects.

      【Key words】 Recurrent spontaneous abortion; Low molecular weight heparin; Aspirin