子痫前期患者应用低分子肝素钙对其肾功能、D-二聚体和凝血功能的影响

Effect of Low Molecular Weight Heparin Calcium on Renal Function, D-dimer and Coagulation Function in Patients with Preeclampsia

目的:探讨子痫前期患者应用低分子肝素钙对其肾功能、D-二聚体(D-D)和凝血功能的影响。方法:将本院102例子痫前期患者以奇偶数法分为A组(对症治疗+硫酸镁)与B组(A组治疗+低分子肝素钙),各51例。比较两组用药前后肾功能、D-D、凝血功能、血压及分娩结局情况。结果:两组治疗后24 h尿蛋白和血尿酸水平均较治疗前降低,且B组各指标均低于A组(P<0.05);两组治疗后凝血酶时间(TT)和活化部分凝血活酶时间(APTT)水平均较治疗前延长,且B组指标均长于A组(P<0.05);两组治疗前后血小板平均容积(MPV)、纤维蛋白原(Fbg)、血小板计数(PLT)、凝血酶原时间(PT)、D-D及尿素氮和血肌酐水平比较,差异均无统计学意义(P>0.05);两组用药后血压均低于用药前(P<0.05),组间比较差异无统计学意义(P>0.05);B组自然分娩率和Apgar≥7分的新生儿比例均高于A组(P<0.05),但胎儿窘迫、产后出血等结局比较差异均无统计学意义(P>0.05)。结论:子痫前期患者应用低分子肝素钙能在一定程度上改善患者肾功能和凝血功能,且用药安全性较高,但对血压影响不明显。

Objective: To investigate the effects of Low Molecular Weight Heparin Calcium(LWHC) on renal function, D-dimer(D-D) and coagulation function in patients with preeclampsia. Method: A total of 102 patients with preeclampsia in our hospital were divided into group A(symptomatic treatment + Magnesium Sulfate) and group B(group A treatment + LWHC) according to the odd even method, 51 cases in each group. The renal function, D-D, coagulation function, blood pressure and delivery outcome of two groups were compared. Result: The 24 h urine protein and serum uric acid levels in two groups were lower than those of before treatment, and the indexes of group B were lower than those of group A(P<0.05). The levels of thrombin time(TT) and activated partial thromboplastin time(APTT) of two groups after treatment were significantly longer than those before treatment, and the indexes of group B were longer than those of group A(P<0.05). There were no significant differences in mean platelet volume(MPV), fibrinogen(Fbg), platelet count(PLT), prothrombin time(PT), D-D, urea nitrogen and serum creatinine levels of two groups before and after treatment(P>0.05). The blood pressures of two groups were lower than those before treatment(P<0.05), but there was no significant difference between two groups(P>0.05). The ratio of natural delivery and Apgar≥7 points in group B were higher than those of group A(P<0.05), but there were no significant differences in outcomes such as fetal distress and postpartum hemorrhage(P>0.05). Conclusion: The application of LWHC in patients with preeclampsia can improve renal function and coagulation function in part, and the safety of medication is higher, but the effect on blood pressure is not obvious.