阿托西班联合地屈孕酮治疗先兆早产的效果及对母婴结局的影响

Efficacy of atosiban combined with dydrogesterone in the treatment of threatened preterm labor and its effects on maternal and infant outcomes

摘要:

目的 探讨阿托西班联合地屈孕酮治疗先兆早产的效果及对母婴结局的影响。方法 按前瞻性、随机研究方法选取2020年1月—2023年4月常州市妇幼保健院收治的先兆早产患者205例，按随机数字表法分为对照组（101例）和实验组（104例）。对照组口服地屈孕酮片，实验组在对照组基础上静脉滴注醋酸阿托西班注射液。两组患者均治疗7 d观察效果。比较两组患者症状消失时间、妊娠延长时间、血清因子、临床疗效、母婴结局，以及药物不良反应发生情况。结果 对照组99例、实验组101例纳入统计分析。实验组症状消失时间短于对照组（P <0.05），妊娠延长时间长于对照组（P <0.05）。实验组治疗前后白细胞介素-6、白细胞介素-8、一氧化氮、前列腺素E2、基质金属蛋白酶组织抑制剂-1、孕酮诱导阻断因子的差值均高于对照组（P <0.05）。实验组总有效率高于对照组（P <0.05）。实验组早产率低于对照组（P <0.05），分娩孕周、新生儿体重、新生儿Apgar评分均高于对照组（P <0.05）。两组总不良反应发生率比较，差异无统计学意义（P >0.05）。结论 阿托西班联合地屈孕酮治疗先兆早产可延长妊娠时间，改善母婴结局及血清因子表达，疗效显著，且安全可靠。

关键词:先兆早产;阿托西班;地屈孕酮;效果;母婴结局

Abstract:

Objective To investigate the efficacy of atosiban combined with dydrogesterone in the treatment of threatened preterm labor and its effects on maternal and infant outcomes.Methods The 205 patients with threatened preterm labor admitted to Changzhou Maternal and Child Health Hospital from January 2020 to April 2023 were selected by the method as the prospective randomized study, and were divided into the control group and the experimental group with the random number table method. The control group was given dydrogesterone tablets orally, and the experimental group was additionally given atosiban acetate injection intravenously. The therapeutic efficacy was observed in the two groups after 7 days of treatment. The duration of symptoms, the prolonged duration of pregnancy, serum factors, clinical efficacy, maternal and infant outcomes, and the incidence of adverse drug reactions were compared between the two groups.Results There were 99 cases in the control group and 101 cases in the experimental group. The duration of symptoms in the experimental group was shorter than that in the control group (P < 0.05), and the prolonged duration of pregnancy in the experimental group was longer than that in the control group (P < 0.05). The differences of levels of interleukin-6, interleukin-8, nitric oxide, prostaglandin E2, tissue inhibitor of metalloproteinase-1 and progesterone-induced blocking factor before and after the treatment in the experimental group were higher than those in the control group (P < 0.05). The overall effective rate of the experimental group was higher than that of the control group (P < 0.05). The rate of preterm birth in the experimental group was lower than that in the control group (P < 0.05), while the gestational week, neonatal birth weight and Apgar scores of newborns in the experimental group were higher than those in the control group (P < 0.05). There was no significant difference in the overall incidence of adverse drug reactions between the two groups (P > 0.05).Conclusions In the treatment of threatened preterm labor, atosiban combined with dydrogesterone may prolong the time to delivery and improve maternal and infant outcomes and expressions of serum factors effectively and safely.

Key words:threatened preterm birth;atosiban;dydrogesterone;efficacy;maternal and infant outcome