[关键词]
[摘要]
目的 比较不同剂量阿司匹林对早发型子痫前期患者临床疗效、母婴结局及凝血功能的影响。方法 选取2019年3月—2020年11月在徐州市第一人民医院进行治疗的123例早发型子痫前期患者,根据用药剂量将患者分为低剂量组、中剂量组和高剂量组。3组患者分别服用阿司匹林肠溶片,于睡前口服,1次/d;用量:高剂量组,150 mg/次;中剂量组,100 mg/d;低剂量组,50 mg/d,至妊娠37周停止用药。观察并比较3组患者临床疗效、母婴结局及凝血功能。结果 治疗后,3组患者收缩压、舒张压及蛋白尿定量均显著降低(P<0.05);且高剂量组及中剂量组收缩压、舒张压及蛋白尿定量指标显著低于低剂量组(P<0.05)。治疗后,中剂量组患者剖宫产及早产几率分别为4.88%及7.32%,均显著低于高剂量组及低剂量组(P<0.05),中、低剂量组产后出血几率均为2.44%,显著低于高剂量组(P<0.05),3组低体质量新生儿及围产儿死亡率均无显著差异。治疗后,3组凝血酶原时间、凝血酶时间均显著延长,纤维蛋白原和D-二聚体水平显著降低(P<0.05);治疗后,高剂量组凝血酶原时间、凝血酶时间均显著高于低、中剂量组,高剂量组纤维蛋白原水平显著低于低、中剂量组,低剂量组D-二聚体水平显著低于中、高剂量组(P<0.05)。结论 对早发型子痫前期患者中剂量(100 mg/d)阿司匹林治疗能够有效改善患者症状及母婴结局,同时对患者凝血功能影响较低,具有良好的有效性及安全性,值得推广。
[Key word]
[Abstract]
Objective To compare the effects of different doses of aspirin on clinical efficacy, maternal and infant outcomes and blood coagulation function of patients with early onset preeclampsia. Methods A total of 123 patients with early-onset preeclampsia who were treated in Xuzhou No.1 Peoples Hospital from March 2019 to November 2020 were selected and divided into high-dose group, medium-dose group and high-dose group according to medication dosage. 3 groups were given Aspirin Enteric-coated Tablets, once daily before going to bed. Dosage: high dose group, 150 mg/time; medium dose group, 100 mg/d, low dose group, 50 mg/d was discontinued at 37 weeks gestation. Clinical efficacy, maternal and infant outcomes and coagulation function of the 3 groups were observed and compared. Results After treatment, systolic blood pressure, diastolic blood pressure, and proteinuria in 3 groups were significantly decreased (P < 0.05). The quantitative indexes of systolic blood pressure, diastolic blood pressure, and proteinuria in high-dose and medium-dose groups were significantly lower than those in low-dose group (P < 0.05). After treatment, the rates of cesarean section and premature delivery in the medium-dose group were 4.88% and 7.32%, respectively, which were significantly lower than those in the high-dose group and the low-dose group (P < 0.05). The rates of postpartum hemorrhage in the medium-dose group and the low-dose group were 2.44%, which were significantly lower than those in the high-dose group (P < 0.05). There were no significant differences in the mortality rates of low-weight neonates and perinatal infants among the three groups. After treatment, prothrombin time and thrombin time in 3 groups were significantly prolonged, while fibrinogen and D-dimer levels were significantly decreased (P < 0.05). After treatment, prothrombin time and thrombin time in high-dose group were significantly higher than those in low-dose and medium-dose groups, the fibrinogen level in high-dose group was significantly lower than that in lowdose and medium-dose groups, and the D-dimer level in low-dose group was significantly lower than that in medium-dose and highdose groups (P < 0.05). Conclusion For patients with early onset preeclampsia, medium dose (100 mg/d) aspirin can effectively improve the symptoms and maternal and infant outcomes, and has a low effect on the coagulation function of patients. It has good efficacy and safety, and is worthy of promotion.
[中图分类号]
R984
[基金项目]
江苏省妇幼健康重点学科建设项目资助课题(苏卫办妇幼【2017】16号)