【摘要】：目的：有多項(xiàng)臨床試驗(yàn)提出肝素聯(lián)合阿司匹林較單用阿司匹林治療抗磷脂抗體綜合征(antiphospholipid syndrome,APS)導(dǎo)致的復(fù)發(fā)性流產(chǎn)的效果更好，本研究搜集所有關(guān)于肝素聯(lián)合阿司匹林治療APS引起的復(fù)發(fā)性流產(chǎn)的隨機(jī)對照試驗(yàn)進(jìn)行Meta分析，以此來評價(jià)肝素聯(lián)合阿司匹林治療APS引起的復(fù)發(fā)性流產(chǎn)的療效和安全性，從而為臨床治療復(fù)發(fā)性流產(chǎn)提供可靠的循證醫(yī)學(xué)證據(jù)。 方法：在數(shù)據(jù)庫中如PubMed、MEDLINE、E M BASE和相關(guān)期刊論文檢索以APS引起的復(fù)發(fā)性流產(chǎn)患者為研究對象，并進(jìn)行了肝素聯(lián)合阿司匹林（聯(lián)合組）與單用阿司匹林（對照組）比較的隨機(jī)對照試驗(yàn)（randomized controlled trial,RCT）研究，對符合入選標(biāo)準(zhǔn)的文獻(xiàn)對其療效和安全性進(jìn)行Meta分析。 結(jié)果：共有9篇文獻(xiàn)符合入選標(biāo)準(zhǔn)，并進(jìn)行了療效和安全性的評價(jià)。聯(lián)合組的新生兒出生率明顯升高，RR=1.32，95%CI[1.22,1.42]，P0.00001，差異有統(tǒng)計(jì)學(xué)意義。聯(lián)合組新生兒體重、早產(chǎn)率、胎兒生長受限、子癇前期發(fā)生率、出血情況較治療組無統(tǒng)計(jì)學(xué)差異。 結(jié)論：聯(lián)合應(yīng)用肝素和阿司匹林較單用阿司匹林治療APS陽性的復(fù)發(fā)性流產(chǎn)可提高活產(chǎn)率，同時(shí)不會增加早產(chǎn)、胎兒生長受限、子癇前期以及出血的風(fēng)險(xiǎn)。
[Abstract]:Objective: several clinical trials have suggested that heparin combined with aspirin is more effective than aspirin alone in the treatment of recurrent abortion induced by anti-phospholipid antibody syndrome (antiphospholipid syndrome,APS). In order to evaluate the efficacy and safety of heparin combined with aspirin in the treatment of recurrent abortion induced by APS, we collected all randomized controlled trials of heparin combined with aspirin to evaluate the efficacy and safety of Meta analysis in the treatment of recurrent abortion caused by APS. So as to provide reliable evidence-based medical evidence for the clinical treatment of recurrent abortion. Methods: in databases such as PubMed,MEDLINE,E M BASE and Chinese Journal Full-text Database, the patients with recurrent abortion caused by APS were studied. A randomized controlled trial (randomized controlled trial,RCT) study of heparin combined with aspirin (combined group) and single aspirin (control group) was carried out. Meta analysis was performed on the efficacy and safety of heparin combined with aspirin. Results: a total of 9 articles met the inclusion criteria and evaluated the efficacy and safety. The birth rate of newborns in the combined group was significantly higher, RR=1.32,95%CI [1.22 鹵1.42], P 0.00001, the difference was statistically significant. There was no significant difference in neonatal weight, premature delivery rate, fetal growth restriction, preeclampsia and bleeding in the combined group. Conclusion: the combination of heparin and aspirin in the treatment of APS positive recurrent abortion can increase the rate of live delivery without increasing the risk of premature delivery, fetal growth restriction, preeclampsia and hemorrhage.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R714.21

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本文編號：2360543