小剂量肝素治疗重度子痫前期临床效果及对血清IL-10含量的影响

Clinical Effect of Low-dose Heparin in Treatment of Patients with Severe Pre-eclampsia and Its Influence on IL-10 in Serum

目的探讨小剂量肝素对重度子痫前期治疗效果及对孕妇血清白细胞介素10（IL-10）水平的影响。方法选择我院收治的重度子痫前期40例,随机分为治疗组和对照组,每组20例。对照组予5%葡萄糖注射液1000 ml＋25%硫酸镁60 ml,每日1次维持静脉滴注;治疗组在此基础上加用肝素25 mg,每日1次维持静脉滴注6~8 h。监测两组平均动脉压、尿量、红细胞压积、产后出血及孕产妇、新生儿预后,并监测两组孕妇血清IL-10的含量。结果治疗后两组平均动脉压、红细胞压积、尿量均较治疗前明显改善,差异均有统计学意义（P〈0.05）,治疗组各指标改善情况优于对照组,差异均有统计学意义（P〈0.05）。两组产后出血、新生儿Apgar评分0~3分及孕周延长致35周以上分娩的发生率比较差异无统计学意义（P〉0.05）,治疗组新生儿Apgar评分4~7分发生率为10%,对照组为30%,差异有统计学意义（P〈0.05）。治疗组治疗前后IL-10分别为（3.8±1.1）pg/ml、（5.7±0.7）pg/ml,对照组分别为（3.9±0.9）pg/ml、（4.0±0.7）pg/ml。两组治疗前比较差异无统计学意义（P〉0.05）;治疗后治疗组IL-10明显高于治疗前及对照组,差异均有统计学意义（P〈0.05）;对照组治疗后血清IL-10含量升高,但与治疗前比较差异无统计学意义（P〉0.05）。结论小剂量肝素治疗重度子痫前期能升高血清IL-10含量,提示肝素能通过抑制炎性反应达到治疗重度子痫前期的作用。

Objective To discuss the clinical effects of low-dose heparin in the treatment of patients with severe pre-eclampsia and its influence on IL-10 in serum.Methods 40 patients with severe pre-eclampsia in our hospital were randomly divided into treatment group and control group with 20 patients in each group.The control group received 5% glucose injection（1000 ml） ＋25% magnesium sulfate（60 ml）,and were kept to intravenous infusion once a day;the treatment group was added with heparin 25 mg based on the treatment of control group and kept to intravenous infusion 6 to 8 h once a day.The mean arterial pressure,urine volume,hematocrit and serum IL-10 content of the two groups were detected,and postpartum hemorrhage,maternal and neonatal prognosis were observed.Results The mean arterial pressure,hematocrit and urine volume in the two groups significantly improved when compared with that before treatment,and the difference was statistically significant（P0.05）,and the improvement in the treatment group was better than that in the control group,and the difference was statistically significant（P0.05）.There was no statistically significant difference of the incidence of postpartum hemorrhage,neonatal Apgar score with 0 to 3 and parturition in more than 35 weeks gestation between the two groups（P0.05）;the rate of neonatal with Apgar score 4 to 7 in the treatment group was 10%,but 30% in the control group,and the difference was statistically significant（P0.05）.Serum IL-10 contents in the treatment group were（3.8±1.1） pg/ml before treatment and（5.7± 0.7） pg/ml after treatment,but in control group they were（3.9± 0.9） pg/ml and（4.0± 0.7） pg/ml respectively.Comparison of IL-10 content of the two groups showed no significant differences before treatment（P0.05）,but in the treatment group IL-10 content after treatment was significantly higher than that before treatment and also higher than that in the control group and the difference was statistically significant（P0.05）;IL-10 content in the control group increased after treatment,but it showed no statistically significant difference（P0.05）.Conclusion Low-dose heparin in the treatment of severe pre-eclampsia can increase serum IL-10 content,which suggests that heparin may inhibit the inflammatory response which may be significant in the treatment of severe preeclampsia.