研究维生素E、低分子肝素联合硫酸镁治疗早发型子痫前期的疗效

Study the efficacy of vitamin E, low molecular weight heparin and magnesium sulfate in the treatment of early onset preeclampsia

目的研究维生素E、低分子肝素(LMWH)联合硫酸镁治疗早发型子痫前期的疗效。方法 200例早发型子痫前期产妇,随机分为观察组和对照组,各100例。对照组产妇使用硫酸镁治疗,观察组则给予维生素E、低分子肝素和硫酸镁联合治疗。观察比较两组的血小板计数(PLT)、D-二聚体(D-D)、24 h尿蛋白、活化部分凝血酶原时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、产妇自觉症状改善率、胎儿平均年龄和新生儿体重。结果两组产妇的PLT和PT比较差异无统计学意义(t=1.935、1.785,P>0.05)。观察组产妇的24 h尿蛋白、D-D水平明显低于对照组,APTT和TT明显高于对照组,差异均具有统计学意义(t=2.102、22.998、3.904、8.714,P<0.05)。观察组的产妇自觉症状改善率98.00%、胎儿平均年龄(235.13±20.12)d和新生儿体重(1980.49±50.72)g均高于对照组的80.00%、(221.46±18.33)d、(1698.59±47.36)g,差异具有统计学意义(P<0.05)。结论在早发型子痫前期,使用维生素E、低分子肝素和硫酸镁联合治疗,可以帮助产妇降低血压,减缓病情的发展恶化,更好地改善妊娠结局。

Objective To study the efficacy of vitamin E, low molecular weight heparin（LMWH） and magnesium sulfate in the treatment of early onset preeclampsia. Methods A total of 200 puerpera with early onset preeclampsia were randomly divided into observation group and control group, with 100 cases in each group. The control group was treated with magnesium sulfate, and the observation group was treated with vitamin E, low molecular weight heparin and magnesium sulfate. Observation and comparison were made on Platelet count（PLT）, D-dimer（D-D）, 24 h urine protein, activated partial thromboplastin time（APTT）, prothrombin time（PT）, thrombin time（TT）, maternal conscious symptom improvement rate, fetal average age and neonatal weight between two groups. Results Both groups had no statistically significant difference in PLT and PT（t=1.935, 1.785, P〉0.05）. The observation group had obviously lower 24 h urine protein and D-D level than the control group, and obviously higher APTT and TT than the control group. Their difference was statistically significant（t=2.102, 22.998, 3.904, 8.714, P〈0.05）. The observation group had maternal conscious symptom improvement rate as 98.00%, fetal average age as（235.13±20.12） d and neonatal weight as（1980.49±50.72） g, which were all higher than 80.00%,（221.46±18.33） d and（1698.59±47.36） g in the control group, and their difference was statistically significant（P〈0.05）. Conclusion For the treatment of early onset preeclampsia, combination of vitamin E, low molecular weight heparin and magnesium sulfate can help puerpera reduce blood pressure, slow down the development of the disease and improve the outcome of pregnancy.