小剂量阿司匹林联合硝苯地平及硫酸镁治疗子痫前期临床评价

Clinical Evaluation of Low-Dose Aspirin Combined with Nifedipine and Magnesium Sulfate in the Treatment of Preeclampsia

目的探讨小剂量阿司匹林联合硝苯地平及硫酸镁治疗子痫前期的临床疗效及对妊娠结局的影响。方法选取东方市人民医院2019年5月至2021年5月收治的子痫前期患者103例,按随机抽签法分为观察组(52例)和对照组(51例)。两组患者均予硫酸镁注射液静脉滴注+硝苯地平缓释片口服,观察组患者加服小剂量(25 mg)阿司匹林肠溶片。两组患者均连续治疗4周。结果观察组总有效率为92.31%,显著高于对照组的76.47%(P<0.05)。治疗后,观察组患者的凝血酶原时间、凝血酶时间、活化部分凝血活酶时间均显著长于对照组,纤维蛋白原水平显著低于对照组;胎盘生长因子、可溶性血管内皮生长因子受体1、血清叶酸水平均显著高于对照组(P<0.05)。随访(直至妊娠结束)发现,观察组患者流产、剖宫产、产后大出血、胎儿窘迫、新生儿窒息等的发生率均显著低于对照组(P<0.05)。观察组与对照组不良反应发生率相当(15.38%比9.80%,P>0.05)。结论小剂量阿司匹林联合硝苯地平及硫酸镁治疗子痫前期,能改善患者的凝血功能、血清学指标水平及妊娠结局。

Objective To investigate the clinical efficacy of low-dose aspirin combined with nifedipine and magnesium sulfate in the treatment of preeclampsia and its effect on pregnancy outcomes.MethodsA total of 103 preeclampsia patients admitted to the Dongfang People’s Hospital from May 2019 to May 2021 were selected and divided into the observation group(52 cases)and the control group(51 cases)by the random lottery method.The patients in both groups were given Magnesium Sulfate Injection by intravenous drip and Nifedipine Sustained-Release Tablets by oral administration,on this basis,the patients in the observation group were given low-dose(25 mg)Aspirin Enteric-Coated Tablets.Both groups were treated continuously for four weeks.ResultsThe total effective rate in the observation group was 92.31%,which was significantly higher than 76.47%in the control group(P<0.05).After treatment,the prothrombin time(PT),thrombin time(TT)and activated-partial thromboplastin time(APTT)in the observation group were significantly longer than those in the control group,and the level of fibrinogen(Fib)in the observation group was significantly lower than that in the control group(P<0.05).The levels of placental growth factor(PLGF),soluble vascular endothelial growth factor receptor 1(sFlt-1)and serum folate(FA)in the observation group were significantly higher than those in the control group(P<0.05).The follow-up results(until the end of pregnancy)showed that the incidence of abortion,cesarean section,postpartum hemorrhage,fetal distress,and neonatal asphyxia in the observation group was significantly lower than that in the control group(P<0.05).The incidence of adverse drug reactions in the observation group was similar to that in the control group(15.38%vs.9.80%,P>0.05).ConclusionLow-dose aspirin combined with nifedipine and magnesium in the treatment of preeclampsia can improve the level of coagulation function,serological indicators and pregnancy outcomes.