国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2019, Vol. 38 ›› Issue (2): 104-107.

• 论著 • 上一篇    下一篇

早期抗凝干预治疗对冻融胚胎移植前高D-二聚体患者妊娠结局的影响

罗希，周从容，黄永俐，吕晶，潘莉娜   

  1. 550000 贵阳，贵州医科大学附属医院生殖中心
  • 收稿日期:2018-11-29 修回日期:2019-02-01 出版日期:2019-03-15 发布日期:2019-03-15

Effect of Early Anticoagulation Intervention on Pregnancy Outcome in Patients with High D-dimer before Freezing Embryo Transfer

LUO Xi，ZHOU Cong-rong，HUANG Yong-li，LYU Jing，PAN Li-na   

  1. Reproductive Medicine Center of Affiliated Hospital of Guizhou Medical University，Guiyang 550000，China
  • Received:2018-11-29 Revised:2019-02-01 Published:2019-03-15 Online:2019-03-15

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摘要： 目的：探讨冻融胚胎移植（FET）前高D-二聚体患者的早期抗凝干预治疗对妊娠结局的影响。方法：选取2016年10月—2017年10于贵州医科大学附属医院生殖中心进行FET的不孕患者89例，检测FET前一日D-二聚体水平，选取浓度＞0.5 μg/mL的患者，并随机分为干预组（43例）和对照组（46例），干预组予小剂量阿司匹林或低分子肝素钠治疗，对照组未行抗凝干预治疗。比较2组D-二聚体水平及着床率、临床妊娠率、早期流产率的差别。结果：2组间D-二聚体浓度、着床率和临床妊娠率比较差异无统计学意义（P＞0.05），而干预组的流产率低于对照组，差异有统计学意义（P＜0.05）。结论：FET前对高D-二聚体的患者予低分子肝素或小剂量阿司匹林行早期抗凝干预治疗，可能改善患者的妊娠结局。

关键词: 受精, 体外, 胚胎移植, 纤维蛋白纤维蛋白原降解物, 阿司匹林, 肝素, 低分子量, 妊娠结局, 治疗

Abstract: Objective：To analyze the effect of early anticoagulation intervention on pregnancy outcome in patients with high D-dimer before freezing embryo transfer (FET). Methods：A total of 89 patients undergoing FET were included in the present study. The level of D-dimer on the day before FET was measured. Those patients with high D-dimer (more than 0.5 μg/mL) were randomly divided into two groups: the treatment group (43 patients) and the control group (46 patients). Patients in the treatment group were treated with low-dose aspirin or low-molecular-weight heparin sodium, while patients in the control group were not treated. The D-dimer level, implantation rate, clinical pregnancy rate and early abortion rate were compared between the two groups. Results：There were no significant differences in D-dimer concentration, implantation rate and clinical pregnancy rate between the two groups (P＞0.05). However, the abortion rate in the treatment group was significantly lower than that in the control group (P＜0.05). Conclusions：Early anticoagulation therapy with low dose aspirin or low molecular weight heparin in those patients with the high level of D-dimer before FET can improve the pregnancy outcome.

Key words: Fertilization in vitro, Embryo transfer, Fibrin fibrinogen degradation products, Aspirin, Heparin, low-molecular-weight, Pregnancy outcome, Therapy