小剂量阿司匹林治疗妊娠期高血压的疗效及对其血液高凝状态的影响

Effect of low-dose aspirin on pregnancy-induced hypertension and its influence on blood hypercoagulability

目的 观察小剂量阿司匹林治疗妊娠期高血压的疗效及对其血液高凝状态的影响。方法 66例妊娠期高血压患者,根据数字随机表法分成对照组和观察组,各33例。对照组采取淀粉安慰剂治疗,观察组采取小剂量阿司匹林治疗。比较两组治疗前后临床症状积分、凝血功能、血液流学变、生活质量评分。结果 治疗前,对照组视力模糊、尿量减少、双下肢水肿、蛋白尿积分分别为(3.58±1.78)、(3.25±1.65)、(3.17±1.57)、(3.80±1.27)分,观察组分别为(3.31±1.20)、(3.13±1.57)、(3.26±1.17)、(3.51±1.30)分;治疗后,对照组视力模糊、尿量减少、双下肢水肿、蛋白尿积分分别为(2.77±1.32)、(2.17±0.96)、(1.76±0.20)、(1.96±0.76)分,观察组分别为(1.68±0.65)、(1.09±0.82)、(0.69±0.15)、(0.73±0.22)分。治疗后,两组视力模糊、尿量减少、双下肢水肿、蛋白尿积分较于治疗前均呈下降趋势,且观察组下降趋势大于对照组(P<0.05)。治疗前,对照组凝血酶原时间、活化部分凝血活酶时间、纤维蛋白原分别为(10.69±1.26)s、(29.14±3.38)s、(5.65±1.77)g/L,观察组分别为(11.09±1.23)s、(28.13±3.96)s、(5.70±1.80)g/L;治疗后,对照组凝血酶原时间、活化部分凝血活酶时间、纤维蛋白原分别为(12.28±1.70)s、(32.23±3.07)s、(4.46±1.23)g/L,观察组分别为(13.08±1.51)s、(36.53±3.20)s、(3.43±0.97)g/L。治疗后,两组凝血酶原时间、活化部分凝血活酶时间较于治疗前均呈上升趋势,纤维蛋白原较于治疗前均呈下降趋势,且观察组升降趋势大于对照组(P<0.05)。治疗前,对照组全血粘度、血浆粘度、红细胞压积分别为(6.39±0.28)mPa·s、(1.80±0.27)mPa·s、(40.02±4.86)%,观察组分别为(6.51±0.30)mPa·s、(1.86±0.23)mPa·s、(40.09±4.71)%;治疗后,对照组全血粘度、血浆粘度、红细胞压积分别为(5.28±0.22)mPa·s、(1.31±0.21)mPa·s、(37.91±3.71)%,观察组分别为(4.08±0.25)mPa·s、(1.09±0.12)mPa·s、(30.86±3.60)%。治疗后,两组全血粘度、血浆粘度、红细胞压积较于治疗前均呈下降趋势,且上述指标观察组下降趋势大于对照组(P<0.05)。治疗后,两组生理、心理、独立性、社会关系、环境、精神支柱评分较于治疗前均呈上升趋势,且观察组上升趋势大于对照组(P<0.05)。结论 小剂量阿司匹林治疗妊娠期高血压疗效确切,其能够改善患者血液高凝状态,预后良好。

Objective To observe the effect of low-dose aspirin on pregnancy-induced hypertension and its influence on blood hypercoagulability.Methods 66 patients with pregnancy-induced hypertension were divided into a control group and an observation group according to random numerical table method,with 33 cases in each group.The control group was treated with starch placebo,and the observation group was treated with low-dose aspirin.The scores of clinical symptoms,coagulation function,hematology and quality of life were compared between the two groups before and after treatment.Results Before treatment,the scores of blurred vision,decreased urine volume,lower limb edema and proteinuria in the control group were(3.58±1.78),(3.25±1.65),(3.17±1.57)and(3.80±1.27)points;in the observation group,the scores were(3.31±1.20),(3.13±1.57),(3.26±1.17)and(3.51±1.30)points.After treatment,the scores of blurred vision,decreased urine volume,lower limb edema and proteinuria in the control group were(2.77±1.32),(2.17±0.96),(1.76±0.20)and(1.96±0.76)points;in the observation group,the scores were(1.68±0.65),(1.09±0.82),(0.69±0.15)and(0.73±0.22)points.After treatment,the scores of blurred vision,decreased urine volume,lower limb edema and proteinuria in both groups showed a decreasing trend compared with those before treatment,and the decreasing trend in the observation group was greater than that in the control group(P<0.05).Before treatment,the prothrombin time,activated partial prothrombin time and fibrin in the control group were(10.69±1.26)s,(29.14±3.38)s and(5.65±1.77)g/L;in the observation group,they were(11.09±1.23)s,(28.13±3.96)s and(5.70±1.80)g/L.After treatment,the prothrombin time,activated partial prothrombin time and fibrin in the control group were(12.28±1.70)s,(32.23±3.07)s and(4.46±1.23)g/L;in the observation group,they were(13.08±1.51)s,(36.53±3.20)s and(3.43±0.97)g/L.After treatment,the prothrombin time and activated partial prothrombin time in both groups showed an increasing trend compared with those before treatment,and the fibrin showed a decreasing trend compared with those before treatment,and the increasing trend of the observation group was greater than that in the control group(P<0.05).Before treatment,the whole blood viscosity,plasma viscosity and hematocrit in the control group were(6.39±0.28)mPa·s,(1.80±0.27)mPa·s and(40.02±4.86)%;in the observation group,they were(6.51±0.30)mPa·s,(1.86±0.23)mPa·s and(40.09±4.71)%.After treatment,the whole blood viscosity,plasma viscosity and hematocrit in the control group were(5.28±0.22)mPa·s,(1.31±0.21)mPa·s and(37.91±3.71)%;in the observation group,they were(4.08±0.25)mPa·s,(1.09±0.12)mPa·s and(30.86±3.60)%.After treatment,the whole blood viscosity,plasma viscosity and hematocrit in both groups showed a decreasing trend compared with those before treatment,and the decreasing trend in the observation group was greater than that in the control group(P<0.05).After treatment,the scores of physiology,psychology,independence,social relationship,environment and spiritual support in both groups showed an increasing trend compared with that before treatment,and the increasing trend in observation group was greater than that in control group(P<0.05).Conclusion Low-dose aspirin is effective in the treatment of pregnancy-induced hypertension.It can improve blood hypercoagulability and has a good prognosis.