目的：探讨烯丙雌醇片联合阿托西班对晚期先兆流产（LTA）患者子宫血流情况及保胎结局的影响。方法：研究对象选择2024年3月~2025年12月就诊于我院的125例LTA患者，基于随机数字表法将其分别列为常规组（62例）、试验组（63例），常规组采用阿托西班治疗，试验组采用烯丙雌醇片联合阿托西班治疗，比较两组患者的激素水平，胎盘功能，子宫血流动力学及治疗安全性。所有患者均随访至妊娠终止，比较两组患者的保胎结局。结果：治疗后，试验组的孕酮（P）、雌三醇（E3）、人绒毛促性腺激素（hCG）均高于常规组，前列腺素E2（PGE2）低于常规组（t=5.195，5.251，11.029，6.031；P＜0.05）。试验组的胎盘生长因子（PIGF）、妊娠相关血浆蛋白A（PAPP-A）、胎盘血管化-血流指数（VFI）均高于常规组，胎盘弹性模量均值（Emean）低于常规组（t=5.869，5.387，4.267，6.936；P＜0.05）。试验组的子宫收缩期与舒张末期流速比值（S/D）、阻力指数（RI）、搏动指数（PI）分别为（1.22±0.45）、（0.41±0.12）、（0.66±0.13），均低于常规组[（1.94±0.33）、（0.72±0.11）、（0.97±0.12）]，平均血流量（Vm）（18.53±3.31）cm/s高于常规组（16.27±3.15）（t=10.188，15.049，13.848，3.909；P＜0.05）。试验组的药物相关副反应发生率与常规组比较，差异无统计学意义（P＞0.05）。截至随访结束时，试验组的保胎成功率、活产率分别为92.06%（58/63）、85.71%（54/63），均高于常规组[79.03%（49/62）、69.35%（43/62）]，早产率、流产率分别为6.35%（4/63）、3.17%（2/63），均低于常规组[12.90%（8/62）、16.13%（10/62）]（x2=4.305，4.811，38.821，36.634；P＜0.05）。结论：烯丙雌醇片联合阿托西班可调节LTA患者激素水平并改善胎盘功能，可在避免增加治疗风险同时，改善子宫血流动力学及保胎结局。
Objective:To explore the effects of allylestrenol tablets combined with atosiban on uterine blood flow and fetal preservation outcomes in patients with LTA.Methods:The research subjects selected 125 LTA patients who visited our hospital from March 2024 to December 2025. Based on the random number table method, they were divided into a control group (62 cases) and an experimental group (63 cases). The control group was treated with atosiban, while the experimental group was treated with a combination of allylestrenol tablets and atosiban. The hormone levels, placental function, uterine hemodynamics, and treatment safety of the two groups of patients were compared. All patients were followed up until the termination of pregnancy, and the fetal preservation outcomes of the two groups of patients were compared.Results:After treatment, the levels of P, E3, and hCG in the experimental group were higher than the control group, while PGE2 was lower than the control group (t=5.195，5.251，11.029，6.031; P<0.05). The PIGF, PAPP-A, and VFI in the experimental group were all higher than the control group, while the Emean was lower than the control group (t=5.869，5.387，4.267，6.936; P<0.05). The S/D,RI, and PI of the experimental group were (1.22 ± 0.45), (0.41 ± 0.12), and (0.66 ± 0.13), lower than the control group [(1.94 ± 0.33), (0.72 ± 0.11), and (0.97 ± 0.12)]. The Vm of (18.53 ± 3.31) cm/s was higher than that of the control group (16.27 ± 3.15) (t=10.188，15.049，13.848，3.909; P<0.05). The incidence of drug-related side effects in the experimental group was similar to the control group (P>0.05). As of the end of the follow-up, the success rate and live birth rate of the experimental group were 92.06% (58/63) and 85.71% (54/63), respectively, both higher than the control group [79.03% (49/62), 69.35% (43/62)]. The premature birth rate and miscarriage rate were 6.35% (4/63) and 3.17% (2/63), respectively, both lower than the control group [12.90% (8/62), 16.13% (10/62)] (x2=4.305，4.811，38.821，36.634; P<0.05).Conclusion:The combination of allylestrenol tablets and atosiban can regulate hormone levels and improve placental function in LTA patients. It can correct uterine hemodynamic disorders and improve fetal outcomes while avoiding increased treatment risks.
