【摘要】 复发性流产(RSA)是指2次及2次以上的自然流产,严重影响女性的生殖和心理健康。研究已发现的RSA病因包括遗传因素、解剖因素、感染因素、内分泌因素和自身免疫病等。然而复发性流产中近半数的病例原因尚不明确,因此被称为不明原因复发性流产(URSA),治疗较为棘手,临床上根据经验给予补充孕酮、抗凝以及免疫调节治疗等,取得了一定的疗效。低分子肝素(LMWH)是一种重要的抗凝剂,同时也具有免疫调节和抗炎效应,应用于URSA的经验治疗,其疗效逐渐被研究者们证实,LMWH可能成为URSA常规而有效的治疗药物,本文主要对URSA的病因、LMWH的作用机制及LMWH对URSA治疗的现状及进展做一综述。更多还原

【Abstract】 Recurrent spontaneous abortion(RSA) refers to two or more clinical pregnancy losses, which greatly threatens women’s reproductive health, and can have a significant psychological toll on affected couples. The etiologies of RSA has been clarified as genetic factors, anatomic factors, infectious factors, endocrine factors and autoimmune diseases. Still, it is difficult to find an etiology in almost half of the RSA cases, and we define them as unexplained recurrent spontaneous abortion(URSA). Accordingly, exerting therapeutic strategies on URSA can also be challenging. Clinicians tend to implement progesterone supplementation, anticoagulation, and/or immunomodulatory treatments for URSA patients, and good results have frequently been achieved. Lower molecular weight heparin(LMWH), as an anticoagulant,has immunomodulatory and anti-inflammatory properties as well, is empirically prescribed in case of URSA, and the efficacy has been verified by researchers over the years. Thus, there is one chance that LMWH becomes one of the standard and effective treating agents for URSA. This article reviews the etiologies of RSA, functional mechanism of LMWH, as well as current treatment of URSA by LMWH and it progress.更多还原