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Clinical efficacy analysis of methotrexate treating ectopic pregnancy patients with different body mass index |
Cixi City CIlin Hospital of Zhejiang, Zhejiang, |
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Abstract Objective: To explore the clinical efficacy of methotrexate treating ectopic pregnancy patients with different body mass index (BMI). Methods: A total of 98 ectopic pregnancy patients who were treated conservatively in Cixi city Guanhaiwei CIlin hospital from December 2014 to December 2017 were selected. They were divided into group A (BMI≥25) and group B (BMI<25) according to the value of BMI (47 cases in each group). According to the random number table method, patients in A and B groups were further divided into group A1 and group A2, group B1 and group B2. All patients were treated conservative by methotrexate. The patients in group A1 and group B1 were treated by multiple low-dose methotrexat (0.4mg/kg/d, continuous treatment for 5 days), and the patients in group A2 and group B2 were treated by single large dose methotrexat (50 mg/m2). The treatment efficacy and adverse reactions were compared among the four groups. Results: 7 days after treatment, there was no significant different in the effective rate between group A and group B (P>0.05). Among patients in group A, the effective rate of patients in group A1 was higher than that of patients in group A2 (87.50% vs 68.97%), which had statistically significant difference (Z=11.0, P<0.05). In group B, the effective rate of patients was 84.0% in group B1 and 83.3% in group B2, which had no significant difference (Z=0.02, P<0.05). The incidence of adverse reactions of patients in group A1 and group B1 (26.0%) was significant higher than that in group A2 and group B2 (12.5%) (Z=5.86, P<0.05). Conclusion: Multiple small doses methotrexat used for treating obesity ectopic pregnancy patients (BMI≥25) has better clinical efficacy, but the incidence of adverse reactions is higher, so the obesity patients should be treated appropriate. AS for patients with normal body mass (BMI<25), multiple small doses or single large dose methotrexat has the same curative effect, but single large dose has low incidence of adverse reaction and it is a convenient administration, so it can be used as the first choice for treating ectopic pregnancy patients with normal body mass.
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