小剂量阿司匹林对早发型子痫前期高危孕妇的影响

Effect of low-dose aspirin in high risk pregnant women with early onset preeclampsia

目的探讨小剂量阿司匹林对早发型子痫前期(preeclampsia,PE)高危孕妇的影响。方法选取收治的具有早发型PE孕妇146例,随机分为对照组与观察组,各73例。对照组给予常规管理,观察组在此基础上给予小剂量(每次50 mg,每日1次)阿司匹林治疗。对比2组的妊娠结局,治疗前后检测2组的血压、凝血4项指标。结果治疗后,2组的舒张压(diastolic blood pressure,DBP)、收缩压(systolic blood pressure,SBP)以及纤维蛋白原(fibrinogen,FIB)均较治疗前显著降低,且观察组下降得更明显(P<0.05)。2组的凝血酶原时间(prothrombin time,PT)、凝血酶时间(thrombin time,TT)与活化部分凝血酶时间(activated partial thrombin time,APTT)均显著延长,且观察组显著长于对照组(P<0.05)。观察组的母婴不良结局发生率与对照组比较差异无统计学意义,但观察组的不良结局评分较对照组显著降低(P<0.05)。观察组与对照组的不良反应发生率(5.48%vs.2.74%)比较,差异无统计学意义(P>0.05)。结论小剂量阿司匹林治疗早发型PE能够提高血压控制效果并改善凝血指标,但对妊娠结局的改善作用尚需进一步研究。

Objective To investigate the effect of low-dose aspirin on coagulation indexes and pregnancy outcomes in preeclampsia(PE)patients with early onset.Methods 146 PE patients with early onset were selected and randomly divided into control group and observation group,with 73 cases in each group.The control group was given general treatment,while the observation group received low-dose aspirin treatment(50 mg each time,once a day)on this basis.The pregnancy outcomes of the 2 groups were compared,and the changes of blood pressure and blood coagulation in the 2 groups before and after treatment were compared.Results After treatment,the diastolic blood pressure(DBP),systolic blood pressure(SBP)and fibrinogen(FIB)in the 2 groups were significantly lower than those before treatment,and the observation group was significantly lower than the control group(P<0.05);the prothrombin time(PT),thrombin time(TT)and activated partial thrombin time(APTT)in the 2 groups were significantly prolonged compared with those before treatment.Compared with the control group,the PT,TT and APTT in the observation group was significantly higher(P<0.05).Compared with the control group,the maternal and infant adverse outcomes in the observation group were not significantly different(P>0.05),but the adverse outcome score of the observation group showed a significant decrease compared with the control group(P<0.05).The incidence of adverse reactions in the observation group and the control group was similar(5.48%vs.2.74%),P>0.05.Conclusion Low-dose aspirin is safe and feasible in the treatment of patients with early onset,which can improve blood pressure control and coagulation indexes,but the effect of improving pregnancy outcomes need further study.