低分子肝素对子痫前期患者激肽释放酶基因表达水平的影响

The effect of low molecular weight heparin on kallikrein level in patients with preeclampsia

目的：探讨低分子肝素对子痫前期患者激肽释放酶基因表达的影响。方法：将96例子痫前期患者采用随机数字表法分为观察组和对照组,各48例。对照组给予常规治疗,观察组患者在此基础上给予低分子肝素0.3~0.4 m L,皮下注射,每天1次,直至分娩前12~24 h止。比较2组患者的血压、24 h尿量、尿蛋白定量、血小板、凝血功能、母婴结局和激肽释放酶基因表达情况。结果：观察组患者收缩压、舒张压及尿蛋白定量均明显低于对照组（P〈0.01）,24 h尿量显著高于对照组（P〈0.01）。2组患者血小板、纤维蛋白原、凝血酶原时间和凝血酶时间差异均无统计学意义（P〉0.05）,观察组患者D-二聚体水平显著低于对照组（P〈0.01）。观察组患者新生儿胎龄、体质量及延长妊娠时间均显著高于对照组（P〈0.01）。治疗后观察组患者血液、胎盘和尿中激肽释放酶基因表达水平均显著高于对照组（P〈0.01）。结论：低分子肝素能够有效促进子痫前期患者激肽释放酶基因表达水平升高,改善母婴结局。

Objective： To investigate the effects of low molecular weight heparin on kallikrein level in patients with preeclampsia.Methods： Ninety-six patients with preeclampsia were divided into the observation group and control group by random number table method（ 48 cases each group）. The control group were treated with conventional therapy,the observation group were additionally treated with 0. 3 to 0. 4 m L of low molecular weight heparin by subcutaneous injection based on the conventional therapy,once a day,up to before 12 to 24 h of delivery. The blood pressure,24 h urine volume,urine protein quantity,blood platelet,coagulation function,maternal and neonatal outcomes and pregnancy outcome and kallikrein expression between the two groups were compared. Results： After the treatment,the systolic pressure,diastolic pressure and urine protein quantity in observation group were obviously lower than those in control group（ P〈0. 01）. The 24 h urine volume in observation group was obviously higher than that in control group（ P〈0. 01）. The differences of the blood platelet,fibrinogen,prothrombin time and thrombin time between two groups were not statistically significant after treatment（ P〈0. 05）. The D-dimer level in observation group was obviously lower than that in control group after treatment（ P〈0. 01）. The gestational age,neonatal birth weight and prolonged pregnancy time in observation group were obviously higher than those in control group after treatment（ P〈0. 01）. The kallikrein levels in the blood,placenta and urine in observation group were obviously higher than those in control group after treatment（ P〈0. 01）. Conclusions： The low molecular weight heparin can effectively enhance the kallikrein level in patients with preeclampsia,and improve the maternal and neonatal outcomes.