目的 探討葉酸片聯(lián)合低分子肝素鈣注射液和小劑量阿司匹林腸溶片治療復(fù)發(fā)性流產(chǎn)的臨床療效。方法 選取2016年1月-2016年8月綿陽中心醫(yī)院收治的復(fù)發(fā)性流產(chǎn)患者94例為研究對象，按照數(shù)表法將患者隨機分為對照組和治療組，每組各47例。對照組皮下注射低分子肝素鈣注射液，5 000 IU/次，1次/d；且口服阿司匹林腸溶片，75 mg/次，1次/d。治療組在對照組基礎(chǔ)上口服葉酸片，0.4 mg/次，1次/d。所有患者均于確定妊娠后開始治療，并持續(xù)至臨產(chǎn)或發(fā)生流產(chǎn)、早產(chǎn)。觀察兩組的臨床療效，比較兩組的激素水平、凝血指標、葉酸和同型半胱氨酸（HCY）的情況。結(jié)果 治療后，對照組、治療組的活產(chǎn)率分別為85.11%、93.62%，兩組活產(chǎn)率比較差異無統(tǒng)計學(xué)意義。治療后，兩組人絨毛膜促性腺激素（HCG）、孕酮（P）、雌二醇（E₂）水平均顯著升高，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標明顯高于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，治療組血漿纖溶酶原激活物抑制劑-1（PAI-1）水平明顯降低，治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組PAI-1水平明顯低于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，治療組HCY水平明顯下降，而葉酸水平明顯升高，治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標的改善程度明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 葉酸片聯(lián)合低分子肝素鈣注射液和小劑量阿司匹林腸溶片治療復(fù)發(fā)性流產(chǎn)具有較好的臨床療效，可改善激素水平，降低PAI-1和HCY水平，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical efficacy of Folic Acid Tablets combined with Low-molecular-weight Heparin Calcium Injection and small dose Aspirin Enteric-coated Tablets in treatment of recurrent spontaneous abortion. Methods Patients (94 cases) with recurrent spontaneous abortion in Mianyang Central Hospital from January 2016 to August 2016 were randomly divided into control and treatment groups, and each group had 47 cases. Patients in the control group were subcutaneous injection administered with Low-molecular-weight Heparin Calcium Injection, 5 000 IU/time, once daily. And Patients in the control group were also po administered with Aspirin Enteric-coated Tablets, 75 mg/time, once daily. Patients in the treatment group were po administered with Folic Acid Tablets on the basis of the control group, 0.4 mg/time, once daily. Patients in two groups were treated after pregnancy until delivery, miscarriage, and premature delivery. After treatment, the clinical efficacies were evaluated, and hormone levels, coagulation indexes, folic acid, and HCY in two groups were compared. Results After treatment, live birth rates in the control and treatment groups were 85.11% and 93.62%, respectively, and there was no difference between two groups. After treatment, the levels of HCG, P, and E₂ in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of PAI-1 in the treatment group were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the levels of PAI-1 in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of HCY in two groups were significantly decreased, but the levels of folic acid in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Folic Acid Tablets combined with Low-molecular-weight Heparin Calcium Injection and small dose Aspirin Enteric-coated Tablets has clinical curative effect in treatment of recurrent spontaneous abortion, can improve hormone levels, decrease the levels of PAI-1 and HCY, which has a certain clinical application value.