阿司匹林联合硫酸镁治疗妊娠高血压综合征的疗效观察

Effect of aspirin combined with magnesium sulfate on hypertensive syndrome of pregnancy

目的探讨阿司匹林联合硫酸镁治疗妊娠高血压综合征(HDP)的临床疗效。方法选取2019年1月—2020年11月于临沂市人民医院产科确诊并治疗的114例HDP患者作为研究对象,根据治疗方法的不同,将患者分为对照组和试验组,每组各57例。对照组静脉滴注硫酸镁注射液,20 g与1 000 mL的葡萄糖注射液充分混合,滴速:1~1.5 g/h;1次/d。试验组在对照组的基础上口服阿司匹林肠溶片,100 mg/次,1次/d。4周为1个疗程,两组连续治疗2个疗程。观察两组患者的临床疗效和顺产率,同时比较两组治疗前后的平均动脉压(MAP)水平、凝血酶原时间(PT)、部分活化凝血酶原时间(APTT)、凝血酶时间(TT)和纤维蛋白原(FIB)水平。结果治疗后,试验组总有效率为96.5%,显著高于对照组的78.9%(P<0.05)。治疗后,两组各时间点MAP水平均显著降低(P<0.05);且试验组的MAP水平显著低于同期对照组(P<0.05)。治疗后,两组PT、APTT及TT均显著延长,FIB水平显著降低(P<0.05);试验组凝血功能指标显著优于对照组(P<0.05)。治疗后,试验组顺产率显著高于对照组(P<0.05)。结论阿司匹林联合硫酸镁治疗HDP可显著降低MAP和FIB水平,延长APTT、TT及PT,提高HDP患者的顺产率。

Objective To investigate the clinical efficacy of aspirin combined with magnesium sulfate in the treatment of hypertensive syndrome of pregnancy(HDP). Methods A total of 114 HDP patients diagnosed and treated from January 2019 to November 2020 were selected as the study subjects. According to different treatment methods, the patients were divided into control group and experimental group, with 57 cases in each group. Patients in the control group were iv administered with Magnesium Sulfate Injection, 20 g added into 1 000 mL glucose injection, the drip rate was 1 — 1.5 g/h, once daily. Patients in the experimental group were po administered with Aspirin Enteric-coated Tablets 100 mg/time, once daily on the basis of control group. Four weeks was a course of treatment, and the two groups were treated for two courses. Clinical efficacy and birth rate of two groups were observed, and the mean arterial pressure(MAP), prothrombin time(PT), APTT, TT, and FIB levels before and after treatment were compared between two groups. Results After treatment, the total effective rate of observation group was 96.5%, which was significantly higher than 78.9% of control group(P < 0.05). After treatment, MAP level at each time node in two groups was significantly decreased(P < 0.05). The MAP level in the experimental group was significantly lower than that in the control group(P < 0.05). After treatment, PT, APTT and TT in two groups were significantly prolonged, FIB level was significantly decreased(P <0.05). The coagulation function index of the experimental group was significantly better than that of the control group(P < 0.05).After treatment, the birth rate of experimental group was significantly higher than that of control group(P < 0.05). Conclusion Aspirin combined with magnesium sulfate in treatment of HDP can significantly reduce MAP and FIB levels, prolong APTT, TT and PT, and improve the vaginal delivery rate of HDP patients.