国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2013, Vol. 32 ›› Issue (3): 162-165.

• 论著 • 上一篇    下一篇

阿司匹林联合泼尼松对抗磷脂抗体阳性者行IVF-ET妊娠结局的影响


张 娱, 季静娟 ,刘雨生, 骆丽华, 童先宏   

  1. 230001 合肥， 安徽医科大学附属省立医院生殖医学中心
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2013-05-15 发布日期:2013-05-15
  • 通讯作者: 刘雨生

Effect of Aspirin Combined with Prednisone on Pregnancy Outcome in People with Positive Anti-Phospholipid Antibody Undergoing IVF-ET

ZHANG Yu, JI Jing-juan, LIU Yu-sheng, LUO Li-hua, TONG Xian-hong   

  1. Reproductive Medicine Center, Affiliated Provincial Hospital, Anhui Medical University, Hefei 230001, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2013-05-15 Online:2013-05-15
  • Contact: LIU Yu-sheng

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摘要： 目的：探讨阿司匹林联合泼尼松对抗磷脂抗体阳性者行体外受精-胚胎移植（IVF-ET）妊娠结局的影响。方法：选取抗心磷脂抗体（ＡＣＡ）和（或）抗β2糖蛋白1抗体（Ａβ２ＧＰ１）阳性的不孕症患者52例，其中30例患者于IVF-ET前给予阿司匹林及泼尼松治疗（研究组），余22例患者助孕前不予上述两种药物治疗（对照组），比较2组患者获卵数、受精率、卵裂率、可利用胚胎数、优质胚胎率、临床妊娠率、妊娠早期流产率的差异。结果：研究组和对照组获卵数差异无统计学意义（8.52±4.34 vs. 9.67±4.02，P=0.312），研究组和对照组的受精率（80.43% vs. 72.41%，P=0.032）、卵裂率（98.67% vs. 94.64%，P=0.045）、可利用胚胎率（89.24% vs. 76.73%，P=0.001），优质胚胎率（72.65% vs. 42.77%，P＜0.001）、累积临床妊娠率（66.67% vs. 33.33%，P=0.013）差异有统计学意义，研究组均高于对照组，早期流产率虽低于对照组，但差异无统计学意义（9.09% vs. 50%，P=0.05）。结论：对于抗磷脂抗体阳性不伴有复发性流产史且拟行IVF-ET助孕的患者，助孕前给予小剂量阿司匹林及泼尼松治疗，有助于提高受精率、改善胚胎质量、提高临床妊娠率并可能改善助孕结局。

关键词: 抗体, 抗心脂, 糖蛋白类, β2糖蛋白1, 受精, 体外, 胚胎移植, 泼尼松, 阿司匹林

Abstract: Objective：To investigate the effect of aspinrin combined with prednisone on pregnancy outcome in patients with positive anti-phospholipid antibody（APA） undergoing in vitro fertility-embryo transfer（IVF-ET）. Methods: Fifty-two patients underwent IVF-ET who had positive anticardiolipin（ACA） or/and anti-beta 2 glycoprotein 1 antibody（Aβ2GP1） were randomly divided into two groups，one group treated with aspirin and prednisone at low doses， another untreated as control. Oocyte retrieval number，fertilization rate，cleavage rate，useful embryo rate，high quality embryo rate，implantation rate，clinical pregnancy rate，abortion rate were analyzed. Results: Between two groups，there were not significant differences in the oocyte retrieval rate and abortion rate（8.52±4.34 vs. 9.67±4.02，P=0.312；9.09% vs. 50%，P=0.05）. The treated group had higher fertilization rate （80.43% vs. 72.41%，P=0.032），cleavage rate（98.67% vs. 94.64%，P=0.045）， useful embryo rate （89.24% vs. 76.73%，P=0.001），high quality embryo rate （72.65% vs. 42.77%， P＜0.001）， and clinical pregnancy rate （66.67% vs. 33.33%，P=0.013） than control. Conclusions: Those patients with positive ACA and Aβ2GP1 but without recurrent abortion undergoing IVF-ET can be treated with aspirin and prednisone in low dose，which could be helpful to improve fertility rate， embryo quality，clinical pregnance rate，and IVF-ET outcomes.

Key words: Antibodies, anticardiolipin, Glycoproteins, Beta 2-glycoprotein I, Fertilization in vitro, Embryo transfer, Prednisone, Aspirin