Heparin And Aspirin Efficacy Of Treatment Of Recurrent Spontaneous Abortion And Peripheral Blood PAI-1and T-PA Changes

Objective:The cause of recurrent spontaneous abortion is very complex, may be the result of multiple factors, to increase the difficulty of treatment. The domestic and foreign research that unexplained recurrent spontaneous abortion (URSA) and prethrombotic state (PTS) is closely related to, the coagulation system and fibrinolytic system disorders can lead to recurrent abortion.Plasmin high levels of plasma plasminogen activator inhibitor-1(PAI-1) is an important cause of high blood coagulation state and it is an independent risk factor for arterial and venous thromboembolic disease. Anticoagulant therapy is effective method.The application of combined heparin and aspirin in treatment of URSA, by monitoring the clinical symptoms, laboratory examination, pregnancy outcome to the effectiveness and safety of anticoagulation therapy URSA argument. Study of URSA plasma PAI and plasma tissue plasminogen activator (t-PA) level and its correlation with recurrent spontaneous abortion, further elaboration of the pathogenesis of RSA and provide monitoring indicators for prophylactic anticoagulation. The changes of PAI-1and t-PA before and after the monitoring heparin therapy and traditional therapy group in plasma, heparin can change in plasma of patients with recurrent spontaneous abortion in PAI-1, t-PA, and provide a theoretical basis for the new treatment of heparin in the treatment of recurrent spontaneous abortion.Methods:(1)Choose unexplained recurrent spontaneous abortion patients75. They were randomly divided into heparin treatment group of38cases,37cases of traditional treatment group. At the same time, select normal early pregnancy in30cases as control group.Three groups of age was no significant difference (P>0.05). The number of abortion of two induced abortion groups showes no statistical significance(P>0.05)(2)The traditional treatment group:progesterone administration, human chorionic gonadotropin therapy. Heparin treatment group:on the basis of conventional therapy with low molecular weight heparin or heparin, and oral aspirin therapy.(3)Two treatment groups were to take the maternal blood detection of PAI-l,t-PA and blood routine test, blood coagulation function before treatment and One months after treatment. At the same time take the normal pregnant women blood PAI-1, t-PA.(4) Record the pregnancy outcomes and neonatal birth defects;Whether the adverse reaction of bleeding tendency, this rash heat, gastrointestinal reaction and drug treatment group.(5) SPSS17software was used for statistical analysis. The measurement data is expressed by means±standard deviation. Two groups of platelet count, blood coagulation tests were compared with t test.It uses the analysisi of variance to compare two groups of all. It has statistically significant if the P<0.05.Results:(1)The success pregnancy rate of heparin treatment group was81.58%and59.46%of the conventional treatment group. The difference has statistically significant (P<0.05).(2) The difference of the adverse reactions between two treatment groups is no significance (P>0.05).(3) The level of PAI-1in recurrent spontaneous abortion patients is higher than normal group. The difference has statistically significant (P<0.05). The level of t-PA is lower,but the difference has no significant (P>0.05). No significant sifference between two URSA groups (P>0.05).4) The level of PAI-1after using heparin is lower than before treatment (P<0.05).And the t-PA is higher,but the difference has no significant (P>0.05).(5) The levels of PAI-1and t-PA of the traditional method have no statistical significance comparing with before treatment (P>0.05).(6) Pathological results:Pregnancy villi loser pathology revealed placental or chorionic villus vascular infarction, calcification, fibrinoid deposition etc.Conclusion:1. Recurrent spontaneous abortion patients have reduced fibrinolytic activity, enhanced coagulation function, blood coagulation and fibrinolytic function disorder.2.Heparin and aspirin can change the coagulation status of patients with recurrent spontaneous abortion.3. Heparin and aspirin in the treatment of recurrent spontaneous abortion can significantly increase the curative effect, and is safe.