低分子肝素联合小剂量阿司匹林对子痫前期高危人群的预防效果分析

Preventing Effect of Low Molecular Heparin and Low-dose Aspirin on Preeclampsia in High-risk Group

目的探讨低分子肝素(LMWH)联合小剂量阿司匹林(LDA)对子痫前期(PE)高危人群的预防效果。方法将笔者医院妇产科收治的94例PE高危人群随机分为对照组(n=31)、肝素组(n=31)和联合组(n=32)。肝素组皮下注射LMWH5000IU,联合组在肝素组基础上,加用阿司匹林75mg/d。比较PE的发生率、APTT与24h尿蛋白量的变化以及妊娠结局。结果肝素组、联合组PE的发生率较对照组明显降低(P<0.05),联合组重度PE的发生率显著低于肝素组(P<0.05)。与对照组比较,治疗后肝素组、联合组24h尿蛋白明显降低,APTT明显延长,且联合组24h尿蛋白明显低于肝素组(P<0.05);与对照组比较,肝素组、联合组早产、胎儿生长迟缓、胎盘早剥、新生儿窒息的发生率明显降低,新生儿出生体重明显升高,联合组胎盘早剥的发生率明显低于肝素组,新生儿出生体重明显高于肝素组(P<0.05)。结论 PE高危人群给予LDA联合LMWH可一定程度降低PE的发生风险和妊娠并发症,改善妊娠结局。

Objective To explore the preventing effect of low molecular heparin （LWMH） and low - dose aspirin（LDA） for pre- eclampsia （PE） in high -risk group. Methods Totally 94 PE in high -risk group who were admitted in obstetrics and gynecology de- partment of our hospital were divided into three groups. LWMH group（n = 31 ） was given LWMH subcutaneous injection for 5000 IU, combined group was given aspirin for 75 mg/d, additionally. The incidence of PE, change of APTT and 24 - hour urine protein, and pregnancy outcome, were compared Results The incidence of PE in LWMH group and combined group was significantly lower than that in control group（ P 〈 0.05 ） , and combined group was significant lower than LWMH group（ P 〈 0.05 ）. Compared with control group, the 24 - hour urine protein in LWMH group and combined group was remarkably reduced, APTT was increased, and the 24 - hour urine pro- tein in combined group was significantly lower than that in LWMH group（P 〈 0.05）. Compared with control group, the incidence of pre- mature delivery, intrauterine growth retardation, abruptio placentae, neonatal asphyxia in LWMH group and combined group was remark- ably reduced, neonate birth weight was increased （ P 〈 0.05 ）. The abruptio placentae in combined group was significantly lower, neonate birth weight was higher than that in LWMH group（P 〈 0.05）. Conclusion LDA combined with LMWH for PE in high - risk group can on some degree reduce the risk of PE and pregnancy complications, and improve the pregnancy outcome.