维生素E联合小剂量阿司匹林对子痫前期高危孕妇母婴结局的改善效果及其可能机制

Improvement effects of vitamin E combined with low-dose aspirin on maternal-infant outcome in pregnant women with high-risk for preeclampsia and its potential mechanism

目的探讨维生素E联合小剂量阿司匹林对子痫前期高危孕妇母婴结局的改善效果及其可能机制。方法选取子痫前期高危孕妇160例,随机分为观察组和对照组,每组80例。两组均于孕12~20周起口服小剂量阿司匹林至孕34周,观察组同时服用维生素E软胶囊,直至妊娠结束。比较两组新生儿一般情况,孕产妇的不良事件,孕妇分娩前血管内皮指标水平和分娩后胎盘组织氧化应激、炎性因子水平。结果观察组新生儿出生时胎龄、身长、头围、体质量均优于对照组,早产儿、极低出生体重儿发生率低于对照组(均P<0.05)。观察组子痫前期发生率低于对照组,子痫前期发病孕周晚于对照组(均P<0.05);观察组内皮素1水平低于对照组,一氧化氮高于对照组(均P<0.05);观察组胎盘组织超氧化物歧化酶、过氧化氢酶水平高于对照组,晚期蛋白氧化产物、活性氧、白细胞介素6和肿瘤坏死因子α水平低于对照组(均P<0.05)。结论与单纯小剂量阿司匹林比较,应用维生素E联合小剂量阿司匹林干预子痫前期高危孕妇,可更好地促进胎儿发育,改善母婴结局,更有效地预防子痫前期,而这可能与其更有效改善血管内皮功能、抑制胎盘氧化应激和炎性反应有关。

Objective To investigate the improvement effects of vitamin E combined with low-dose aspirin on maternal-infant outcome in pregnant women with high-risk for preeclampsia and its potential mechanism.Methods A total of 160 pregnant women with high-risk for preeclampsia enrolled were randomly divided into observation group and control group,with 80 cases in each group.In both groups,oral administration of low-dose aspirin was performed from gestational week 12 to 20 through gestational week 34,in addition,the observation group was administrated Vitamin E Soft Capsules until the end of pregnancy.General condition of neonates,adverse events in pregnant women,maternal vascular endothelial indicators levels before delivery,and the levels of placenta tissue oxidative stress and inflammatory factors after delivery were compared between the two groups.Results The observation group had superior neonatal gestational age,body length,head circumference and body mass at birth,and lower incidence rates of premature infants and very low birth weight infants in comparison with the control group(all P<0.05).Compared with the control group,the observation group had lower incidence rate of preeclampsia,later gestational week of preeclampsia onset(all P<0.05),lower endothelin 1 level,higher nitric oxide(all P<0.05),higher levels of placenta tissue superoxide dismutase and catalase,and lower levels of advanced oxidation protein products,reactive oxygen species,interleukin 6 and tumor necrosis factorα(all P<0.05).Conclusion Compared with simple low-dose aspirin,vitamin E combined with low-dose aspirin can better promote fetal development,improve maternal-infant outcome,prevent preeclampsia more effectively in the intervention of pregnant women with high-risk for preeclampsia,which may be associated with its improving vascular endothelial function more effectively and inhibiting placental oxidative stress and inflammatory response.