小剂量阿司匹林联合硝苯地平对妊娠期高血压患者凝血功能、血管内皮功能及妊娠结局的影响

Effects of low-dose aspirin combined with nifedipine on coagulation function,vascular endothelial function and pregnancy outcome in patients with gestational hypertension

目的观察小剂量阿司匹林联合硝苯地平对妊娠期高血压患者凝血功能、血管内皮功能及妊娠结局的影响。方法将本院2018年1月至2020年12月收治的90例妊娠期高血压患者随机分为对照组和观察组,各45例。对照组给予基础治疗+硝苯地平,观察组在对照组基础上加用小剂量阿司匹林。比较两组的治疗效果。结果治疗后,两组的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)均降低,且观察组低于对照组(P<0.05)。治疗后,两组的活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)均延长,纤维蛋白原(FIB)水平均降低,且观察组优于对照组(P<0.05)。治疗后,两组的内皮素-1(ET-1)、可溶性血管细胞黏附分子-1(sVCAM-1)、晚期糖基化终末产物受体(RAGE)水平均降低,一氧化氮(NO)水平均升高,且观察组优于对照组(P<0.05)。观察组的新生儿不良结局总发生率及产妇不良结局总发生率均低于对照组,差异具有统计学意义(P<0.05)。结论小剂量阿司匹林联合硝苯地平可有效控制妊娠期高血压患者的血压,改善其凝血功能及血管内皮功能,优化妊娠结局。

Objective To observe the effects of low-dose aspirin combined with nifedipine on coagulation function,vascular endothelial function and pregnancy outcome in patients with gestational hypertension.Methods Ninety patients with gestational hypertension admitted in our hospital from January 2018 to December 2020 were randomly divided into control group and observation group,with 45 cases in each group.The control group was given basic treatment and nifedipine,and the observation group was given low-dose aspirin on the basis of the control group.The therapeutic effects of the two groups were compared.Results After treatment,the systolic pressure(SBP),diastolic pressure(DBP)and mean arterial pressure(MAP)of the two groups decreased,and those of the observation group were lower than the control group(P<0.05).After treatment,the activated partial thromboplastin time(APTT),prothrombin time(PT)and thrombin time(TT)of both groups prolonged,the level of fibrinogen(FIB)decreased,and those of the observation group were better than the control group(P<0.05).After treatment,the levels of endothelin-1(ET-1),soluble vascular cell adhesion molecule-1(sVCAM-1)and receptors for advanced glycation end products(RAGE)in both groups decreased,the level of nitric oxide(NO)increased,and those of the observation group were better than the control group(P<0.05).The total incidence of adverse neonatal outcomes and the total incidence of adverse maternal outcomes in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Low-dose aspirin combined with nifedipine can effectively control the blood pressure of patients with gestational hypertension,improve their coagulation function and vascular endothelial function,and optimize the pregnancy outcome.