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Study of Low Molecular Heparin on Women with Antiphospholipid Syndrome and Its Influence of Bone Metabolism

Author: LiPing
Tutor: ZhuFuFan
School: Central South University
Course: Obstetrics and Gynecology
Keywords: Anticardiolipin antibodies Antiphospholipid syndrome Low molecular weight heparin Plasma viscosity Tartrate-resistant acid phosphatase Calcium
CLC: R714.2
Type: Master's thesis
Year: 2007
Downloads: 36
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Abstract

Objects: To compare the therapeutic effect of low molecular heparinwith prednisone and aspirin in antiphospholipid syndrome and observethese influence of bone metabolism、hemorheology and pregnancyoutcome during the therapy.Metheods: A prospective observational study included 40patients(20 pregnancy patients, 20 unpregnancy patients) withanticardiolipin antibody in the study group who received low-molecularheparin. The control group of 40 patients(20 pregnancy patients, 20unpregnancy patients)received prednisone and aspirin. We comparedthese groups according to the pregnancy outcomes、the negative rate ofanticardiolipin antibody(ACA)and the influence of bone metabolism、hemorheology and pregnancy outcome during the therapy, using standardstatistical tests.Results: 1.The number of people with negative anticardiolipinantibody were 5、25 and 32 in the study group,the Clearance rate ofanticardiolipin antibody after one course of treatment、two courses oftreatment、two courses of treatment in the study group were 12.5%、62.5% and 80% and the number of people with negative anticardiolipinantibody were 8、32 and 36 and the Clearance rate of anticardiolipinantibody after one course of treatment、two courses of treatment、twocourses of treatment in the control group were 20%、80%、90%,with theprolonged treatment the Clearance rate of anticardiolipin antibody raisedup,there was significant difference (p<0.05). There was no significantdifference in the Clearance rate of anticardiolipin antibody after onecourse of treatment、two courses of treatment、two courses of treatmentbetween the study group and control group (p>0.05).2. The plasma viscosity of study group were 1.84±0.42、1.49±0.16and 1.41±0.13 before the treatment and after one course and two courses of treatment, there was significant difference in them (p<0.05).Theplasma viscosity were 1.87±0.33、1.62±0.30、1.50±0.20 before thetreatment and after one and two courses of in control group, there wassignificant difference in them (p<0.05). The plasma viscosity of studygroup were lower than the control group, there was significantdifference(p<0.05).3. The concentration of and blood calcium of the study group were2.49±0.18mmol/l、2.47±0.27 mmol/l、2.50±0.26 mmol/l before thetreatment and after one course and two courses of treatment,there was nosignificant difference in them (p>0.05), the concentration of bloodcalcium of the control group were 2.51±0.26 mmol/l、2.48±0.30mmol/l、2.64±0.17mmol/l before the treatment and after one course and twocourses of treatment,there was significant difference between one courseand two courses of treatment (p<0.05),the concentration of blood calciumof the control group before the treatment was different with two coursesof treatment (p<0.05). The concentration of blood calcium of study groupwere lower than the control group after two courses of treatment, therewas significant difference(p<0.05).4.The concentration of and tartrate-resistand acid phosphatase(TRAP)of the study group were 4.35±0.53u/l、4.60±0.74u/l, 4.55±0.56u/l beforethe treatment and after one course and two courses of treatment,there wasno significant difference in them (p>0.05), the concentration of TRAP ofthe control group were 4.28±0.70u/l、5.16±0.59u/l、6.52±0.51 u/l beforethe treatment and after one course and two courses of treatment,there wassignificant difference in them (p<0.05). The concentration of TRAP ofstudy group was lower than the control group after one course and twocourses of treatment, there was significant difference(p<0.05).5. The pregnancy outcomes were 50% and 70% and no differencewas noted for pregnancy outcomes between the study group and controlgroup (p>0.05).Conclusions:1. There was no significant difference in the Clearance rate ofanticardiolipin antibody and pregnancy outcomes between the the therapy with low-molecular heparin and prednisone and aspirin.2. The therapy with low-molecular heparin is better thanprednisone and aspirin to cut down plasma viscosity.3. The influence of low-molecular heparin to bone metabolismwas lower than prednisone and aspirin.4. Tartrate-resistand acid phosphatasewe should test to diagnoseosteoporosis.

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