在妊娠期高血压中使用低分子肝素可以提高子宫动脉阻力指数预测子痫前期和胎儿生长受限

Low-molecular-weight heparin improves the performance of uterine artery Doppler velocimetry to predict preeclampsia and Small-for-gestational age infant in women with gestational hypertension

目的探讨在高危孕妇中短疗程的皮下注射低分子肝素是否能提高子宫动脉阻力指数预测子痫前期和胎儿生长受限。方法挑选24至26周妊娠期高血压患者96名和正常孕妇30名,治疗前和治疗2周后超声多普勒测量子宫动脉阻力指数,58例妊娠期高血压为治疗组,38例妊娠期高血压和30正常孕妇为对照组。结果低分子肝素治疗组子宫动脉阻力指数明显下降,而对照组无明显改变。然而低分子肝素引起的子宫动脉阻力指数减少只局限有正常妊娠结局的产妇,从0.64±0.01降至0.52±0.01(P<0.05)。结论低分子肝素可以提高子宫动脉阻力指数预测子痫前期和胎儿生长受限。

Objective This study investigated whether a short course of subcutaneous low-molecular-weight heparin（LMWH） might improve the performance of uterine artery Doppler to preeclampsia and fetal growth restriction in a high-risk population.Methods A controlled,open-labeled study included 96women with gestational hypertension and 30 healthy women enrolled at 24 to 26 weeks gestation.Doppler evaluation of uterine arteries resistance index（RI） was performed before and after a two-week course of LMWH（enoxaparin,4 000 IU/d,n= 58 hypertensive patients） or no treatment（n=38 hypertensive women and 30 healthy controls）.Results There was a significant decrease of uterine artery RI after LMWH（P0.05,）,whereas the untreated hypertensive patients and the healthy control group showed no change between the two Doppler evaluations.The change induced by LMWH was restricted to women with normal outcome,whose RI decreased from 0.64 ± 0.01 to 0.52± 0.01（P0.05）.Conclusion LMWH improved the performance of uterine artery RI to predict preeclampsia and fetal growth restriction in women with gestational hypertension.