硫酸镁联合低分子肝素治疗早发型子痫前期的疗效观察

Curative effect of Magnesium Sulfate Combined with Low Molecular Heparin in Treatment of Early-onset Preeclampsia

目的:探讨硫酸镁联合低分子肝素治疗早发型子痫前期的临床疗效。方法:选择2011年1月—2015年7月收集104例早发型子痫前期患者作为研究对象,按随机数字表法分为观察组(53例)和对照组(51例)。对照组患者采用硫酸镁常规解痉治疗,观察组患者在对照组治疗的基础上加用低分子肝素,观察2组患者的血压、凝血功能、肾功能、妊娠结局等指标。结果:观察组和对照组患者收缩压为(131.6±9.45)、(142.8±8.15)mm Hg,舒张压为(83.4±4.99)、(89.2±5.77)mm Hg,均较治疗前有明显改善,且观察组患者血压较对照组下降更为明显,差异有统计学意义(P<0.05);观察组患者血浆凝血酶原时间、D-二聚体、活化部分凝血酶时间为(11.50±1.31)s、(393.2±98.24)μg/L、(22.4±1.64)s,均明显优于治疗前,且明显优于对照组,差异有统计学意义(P<0.05);观察组患者肌酐为(63.5±8.33)μmol/L,明显低于对照组的(78.7±11.65)μmol/L,差异有统计学意义(P<0.05);观察组和对照组患者妊娠周期为(32.6±2.22)、(30.4±2.96)周,新生儿体质量为(2 576.2±516.24)(2 178.4±412.09)g,2组的差异均有统计学意义(P<0.05)。结论:硫酸镁联合低分子肝素治疗早发型子痫前期,疗效良好,但对肾功能的改善仍需进一步确定。

OBJECTIVE： To probe into the clinical efficacy of magnesium sulfate combined with low molecular heparin in treatment of early-onset preeclampsia. METHODS： 104 cases of patients with early-onset preeclampsia during Jan. 2012 to Jul. 2014 were collected to be divided into the control group（ 51 cases） and the observation group（ 53 cases） via the random number table. The control group received spasmolysis treatment with magnesium sulfate,and the observation group were additionally treated with low molecular heparin based on the control group. The indexes of blood pressure,blood coagulation,renal function and pregnancy outcome of two group of patients were observed.RESULTS： In the observation group and the control group,the systolic pressure were respectively（ 131. 6 ± 9. 45）mm Hg and（ 142. 8 ± 8. 15） mm Hg,and the diastolic pressure were respectively（ 83. 4 ± 4. 99） mm Hg and（ 89. 2 ±5. 77） mm Hg,both of which had been significantly improved; and the observation group had an obvious decrease compared with the control group,with statistically significant difference（ P〈0. 05）. The indexes of PT、D-D、APTT in observation group were respectively（ 11. 50 ± 1. 31） s,（ 393. 2 ± 98. 24） μg / L,（ 22. 4 ± 1. 64） s,significantly better thanthat before treatment and control group,with statistically significant difference（ P〈0. 05）. Cr of observation group was（ 63. 5 ± 8. 33） μmol/L,significantly lower than that of control group（ 78. 7 ± 11. 65） μmol/L,the difference was statistically significant（ P〈0. 05）. The gestation period of observation group and control group were respectively（ 32. 6 ±2. 22） weeks and（ 30. 4 ±2. 96） weeks,and the neonatal birth weight were respectively（ 2 576. 2 ±516. 24） g and（ 2 178. 4 ± 412. 09） g,there were statistically significant difference between two groups（ P〈0. 05）. CONCLUSIONS：Magnesium sulfate combined with low molecular heparin in treatment of early onset preeclampsia is effective,while the effects on renal function still needs to be confirmed.