小剂量阿司匹林治疗子痫前期高危孕妇的疗效观察

Observation on Efficacy of Low-dose Aspirin in Treatment of High-risk Pregnant Women in Preeclampsia

目的：探讨小剂量阿司匹林治疗子痫前期高危孕妇的临床效果。方法：选取解放军第463医院2012年5月—2015年5月收治的子痫前期高危风险的孕妇119例,按随机数字表法分为观察组59例,对照组60例。观察组患者给予阿司匹林治疗,1日1次,1次100 mg,对照组患者给予安慰剂治疗,均睡前服药,2周为1疗程,2~3疗程结束后,对2组患者妊娠演化（平均出生孕期、新生儿出生体质量、重度子痫前期、轻度子痫前期、早发子痫前期、妊娠诱发高血压、胎儿宫内发育迟缓、流产）结果进行比较。结果：观察组患者平均出生孕期（36.81±2.01）周、新生儿出生体质量（2 890.20±340.12）g,均较对照组的（35.04±3.12）周、（2 611.40±479.25）g低,差异有统计学意义（P〈0.05）。观察组患者重度子痫前期2例（3.38%）,轻度子痫前期11例（18.64%）,早发子痫前期7例（11.86%）,妊娠诱发高血压病2例（3.38%）,胎儿宫内发育迟缓8例（13.56%）、流产1例（1.69%）,均低于对照组的9例（15.00%）,31例（51.67%）,16例（26.67%）,10例（16.67%）,18例（30.00%）,7例（11.67%）,差异有统计学意义（P〈0.05）。治疗期间对2组患者的凝血、纤溶功能进行检测,均未见血小板计数异常,无妊娠期及围产期母儿出血等情况,观察组患者出现1例轻度胃肠道症状,对照组无胃肠道症状出现,2组的差异无统计学意义（t=1.026,P=0.311）。结论：小剂量阿司匹林治疗子痫前期高危孕妇,能有效预防子痫前期的发生,改善母儿结局,值得临床借鉴。

OBJECTIVE： To probe into the clinical efficacy of low-dose aspirin in treatment of high-risk pregnant women in preeclampsia. METHODS： 119 cases of high-risk pregnant women in preeclampsia admitted into Hospital463 of PLA from May 2012 to May 2015 were selected to be divided into observation group（ 59 cases） and control group（ 60 cases） via the random number table. The observation group were treated with aspirin,once a day with100mg; the control group received placebo; drugs were took before bedtime,two weeks as one treatment course. After two to three treatment course,the outcome of evolution of pregnancy（ the average birth pregnancy,neonatal birth weights,severe preeclampsia,mild preeclampsia,early preeclampsia,pregnancy induced hypertension,intrauterine growth retardation and abortion） in two group of patients were compared. RESULTS： The average birth pregnancy and neonatal birth weights of observation group were（ 36. 81 ± 2. 01） weeks and（ 2 890. 20 ± 340. 12） g,significantly lower than that of control group（ 35. 04 ± 3. 12） weeks and（ 2 611. 40 ± 479. 25） g,with statistically significant difference（ P〈0. 05）. In observation group,there were 2 cases of severe preeclampsia（ 3. 38%）,11 cases of mild preeclampsia（ 18. 64%）,7 cases of early preeclampsia（ 11. 86%）,2 cases of pregnancy induced hypertension（ 3. 38%）,8 cases of intrauterine growth retardation（ 13. 56%） and 1 cases of abortion（ 1. 69%）,all of which were significantly lower than that of control group 9 cases（ 15. 00%）,31 cases（ 51. 67%）,16 cases（ 26. 67%）,10 cases（ 16. 67%）,18 cases（ 30. 00%） and 7 cases（ 11. 67%）,with no significant difference（ P〈0. 05）.During the treatment,the coagulation and fibrinolysis function of two group of patients were determined,no abnormal platelet count and no bleeding of mothers and infants in pregnancy and perinatal period were observed; there was1 case with mild gastrointestinal symptoms in observation group,yet no symptom in control group,the difference was not statistically significant（ t = 1. 026,P = 0. 311）. CONCLUSIONS： Low-dose aspirin in treatment of high-risk pregnant women in preeclampsia can effectively prevent the occurrence of preeclampsia and improve the maternal and neonatal outcome,which is worthy of clinical reference.