阿司匹林在子痫前期高风险孕妇中的临床疗效研究

Clinical Efficacy Study of Aspirin in High-risk Pregnant Women with Preeclampsia

目的 探讨阿司匹林改善子痫前期(preeclampsia, PE)高风险孕产妇妊娠结局的作用。方法 回顾性选取2020年12月—2023年10月广州医科大学附属第五医院定期产检的203例PE高风险孕产妇的临床资料,根据是否服用阿司匹林分为对照组和研究组,对照组105例,研究组98例。对照组接受常规产检,研究组在对照组基础上每天加服阿司匹林100 mg。对比两组妊娠结局、新生儿结局及孕产妇治疗前后凝血功能变化。结果 研究组子痫前期发生率4.08%(4/98)、重度子痫前期发生率2.04%(2/98),均低于对照组的12.38%(13/105)、9.52%(10/105),差异有统计学意义(χ^(2)=4.550、5.103,P均<0.05)。两组分娩方式、胎盘早剥发生率、产后出血率比较,差异无统计学意义(P>0.05)。研究组的胎儿生长受限发生率、早产率均低于对照组,新生儿出生体重高于对照组,差异有统计学意义(P均<0.05)。两组新生儿窒息率对比,差异无统计学意义(P>0.05)。治疗后,两组患者凝血酶原时间、活化部分凝血活酶时间、D-二聚体比较,差异无统计学意义(P均>0.05);研究组纤维蛋白原血小板计数低于对照组,差异有统计学意义(P均<0.05)。结论 阿司匹林可降低子痫前期高风险孕产妇的PE发生率,改善新生儿不良结局。

Objective To investigate the effect of aspirin on pregnancy outcomes in pregnant women at high risk of preeclampsia(PE).Methods The clinical data of 203 pregnant women with high risk of PE who underwent regular prenatal examination in the Fifth Affiliated Hospital of Guangzhou Medical University from December 2020 to October 2023 were retrospectively selected.According to whether they took aspirin or not,they were divided into control group and study group,105 cases in control group and 98 cases in study group.The control group received routine prenatal examination,and the study group received aspirin 100 mg daily on the basis of the control group.The pregnancy outcome,neonatal outcome and changes of coagulation function before and after treatment were compared between the two groups.Results The incidence of preeclampsia in the study group was 4.08%(4/98),and the incidence of severe preeclampsia was 2.04%(2/98),which were lower than 12.38%(13/105)and 9.52%(10/105)in the control group,the differences were statistically significant(χ^(2)=4.550,5.103,both P<0.05).There was no significant difference in the mode of delivery,the incidence of placental abruption and postpartum hemorrhage between the two groups(P>0.05).The incidence of fetal growth restriction and premature birth rate in the study group were lower than those in the control group,and the birth weight of the newborn was higher than that in the control group,the differences were statistically significant (all P<0.05). There was no significant difference in neonatal asphyxia rate between the two groups (P> 0.05). After treatment, there was no significant difference in prothrombin time, activated partial thrombolasin time, D dimer between the two groups (all P>0.05), the fibrinogen and the platelet count in the study group were lower than those in the control group, the differences were statistically significant (both P<0.05). Conclusion Aspirin can reduce the incidence of PE in pregnant women at high risk of preeclampsia and improve adverse neonatal outcomes.