低分子量肝素联合硫酸镁治疗早发型子痫前期的疗效观察

Clinical observation of the low-molecular-weight heparin combined with magnesium sulfate treatment for early-onset preeclampsia

目的比较低分子量肝素(LMWH)联合硫酸镁和常规硫酸镁治疗早发型子痫前期的疗效。方法将43例早发型子痫前期患者随机分为研究组(采用LMWH联合硫酸镁治疗,n=23)和对照组(仅采用硫酸镁治疗,n=20),研究组患者采用LMWH皮下注射,7～10d为一疗程,检测两组患者治疗前后的血压、凝血功能、肾功能,母儿并发症和妊娠延长天数等指标。结果两组患者治疗后血压均有所下降,但下降幅度的差异无统计学意义(P>0.05)。治疗后,研究组患者血清D-二聚体水平、24h尿蛋白、随机尿蛋白/尿肌酐比值显著低于对照组(P<0.05),但两组患者治疗前后的血清尿酸、尿素氮、血肌酐比较,差异无统计学意义(P>0.05)。与对照组比较,研究组患者新生儿重度窒息率明显下降,妊娠天数显著延长(P<0.05)。结论 LMWH可能改善子痫前期患者血液的高凝状态和肾功能,对早发型子痫前期具有较好的疗效。

Objective To compare the therapeutic effect of low-molecular-weight heparin（LMWH） combined with magnesium sulfate treatment and conventional magnesium sulfate treatment for early-onset preeclampsia.Methods 43 patients with early-onset preeclampsia were randomly assigned into study group（treated with LMWH and magnesium sulfate,n=23） and control group（treated with magnesium sulfate,n=20）.Patients in study group were subjected to subcutaneous injection with LMWH,with a treatment course of 7-10 days.Indicators such as blood pressure,coagulation function,renal function,maternal and neonatal complications and extended gestational period of patients in the two groups before and after treatment were detected.Results The blood pressure of patients in the two groups decreased after treatment,but the difference of the declining ranges showed no statistically significance（P0.05）.After treatment,levels of serum D-dimer,24 h urine protein,random urine protein-creatinine ratio of patients in study group were significantly lower than those in control group（P0.05）,however,it had no statistical difference when comparing the serum uric acid,urea nitrogen and creatinine of patients in the two groups between before and after treatment（P0.05）.Compared with control group,the incidence of severe neonatal asphyxia of patients was obviously declined and their gestational period was markedly extended in study group（P0.05）.Conclusion LMWH may improve blood hypercoagulability and renal function of patients with preeclampsia,and possesses a better therapeutic effect on treatment for early-onset preeclampsia.