低分子肝素联合硫酸镁用于治疗早发型子痫前期疗效的研究

A Clinical Trial on Early Onset Preeclampsia:the Curative Effect of Low Molecular Weight Heparin Calcium in Combining with Magnesium Sulfate

目的:探讨硫酸镁与低分子肝素(Low molecular weight heparin,LMWH)联合治疗早发型子痫前期(Early onset preeclampsia,EOP)的疗效。方法:将2011年8月-2012年7月收治的23例单胎EOP患者随机单盲分为硫酸镁组和硫酸镁联合LMWH组,采用回顾性方法分析妊娠结局。结果:联合治疗组APTT延长的幅度明显大于硫酸镁组,P=0.030。硫酸镁组TT表现为缩短(P=0.027);两组变化幅度比较,P=0.039。治疗后硫酸镁组血清肌酐增高(P=0.035)。联合治疗组延长妊娠平均时间明显大于硫酸镁组(P<0.05)。联合组围生儿出生体重明显大于硫酸镁组(P<0.05)。结论:硫酸镁联合LMWH治疗EOP优越于传统的单独应用硫酸镁治疗。LMWH能抑制血管内皮受损,改善血液高凝状态,保护肾功能,围生儿孕龄延长及出生体重增加,提高围生儿存活率。

Objective：The curative effect of magnesium sulfate combining with low molecular weight heparin are studied on early onset preeclampsia.Methods：The subjects included 23 early onset preeclampsia patients of singleton pregnancy from August 2011 to July 2012.With single blinded tecknique,the patients were divided into two groups at random：magnesium sulfate group and magnesium sulfate combining with low molecular weight heparin group.The curative effects of two treatments were studied.Results：Data analyses indicated that APTT in joint group was obviously lengthened more than magnesium sulfate group（P=0.030）.TT in joint group was shortened after treatment and there was significant difference（P=0.027）.Significant difference lied in the scope of the changes between two groups（P=0.039）.Significant difference was also found in the increase of concentration of serum uric acid after the treatment in joint group（P=0.03）.SCr in joint group was increased and significantly different before and after the treatment（P=0.035）.The lengthening of expected pregnancy in average was significant difference between two groups（P〈0.05）.Perinatals weighing implied a statistical significance between two groups（P〈0.05）.Conclusion：The study demonstrated magnesium sulfate combining low molecular weight heparin showed an advantageous effect on early onset preeclampsia,compared with traditional magnesium sulfate only treatment.The combined treatment could inhibit the hyper-coagulant state without adverse effect on anti-hypertension,thus promoting renal function and microcirculation.The combined treatment could improve the placenta blood stream irrigation,nurturing fetal growth and enlarging the gestational age and fetal weight.