阿司匹林治疗妊娠期易栓症疗效及对患者血清血管性血友病因子和凝血功能影响

Curative Efficacy of Aspirin in the Treatment of Pregnancy Perithrombosis and the Effects on Serum vWF and Coagulation Function

目的:探讨阿司匹林治疗妊娠期易栓症的疗效及对患者血清血管性血友病因子(v WF)和凝血功能的影响。方法:妊娠期易栓症患者120例随机分为观察组(n=62)和对照组(n=58)。观察组采用阿司匹林治疗;对照组采用低分子肝素治疗。比较两组患者的临床疗效,以及血清v WF、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)水平变化,观察患者妊娠结局和新生儿并发症发生情况。结果:观察组有效率为93.55%,显著高于对照组的75.86%(P<0.05)。治疗后,两组患者血清v WF水平和凝血功能均较前显著改善(P<0.05),且观察组患者血清v WF、PT水平明显低于对照组,APTT显著高于对照组(P<0.05)。两组患者胎盘早剥发生率无明显差异(P>0.05);观察组患者妊娠高血压综合征、胎儿生长受限及不明原因复发性流产发生率均明显低于对照组(P<0.05);两组新生儿巨大儿、死亡发生情况无明显差异(P>0.05),观察组早产儿、窒息及胎儿窘迫发生率显著低于对照组(P<0.05)。结论:阿司匹林治疗妊娠期易栓症患者的疗效较高,可有效改善患者血清v WF、凝血功能水平,新生儿并发症较少,且患者基本可以耐受,值得推广应用。

Objective:To study the curative efficacy of aspirin in the treatment of pregnancy perithrombosis and its effects on vascular hemophilia factor(v WF)and coagulation function.Methods:Totally 8,702 patients giving birth in our hospital from June 2015 to June 2017 were selected for the study,including 120 patients with thrombosis during pregnancy.The patients were randomly divided into the observation group(n=62)and the control group(n=58).The observation group was treated with aspirin.The control group was treated with low molecular weight heparin infusion.The clinical efficacy,serum v WF,activation time of partial thrombin(a PTT)and prothrombin time(PT)levels of the two groups were compared,and the pregnancy outcomes and neonatal complications were observed and recorded.Results:After the treatment,the effective rate of the observation group was 93.55%,which was significantly higher than that(75.86%)of the control group(P<0.05).Before the treatment,there was no significant difference in serum v WF and coagulation function between the groups.After the treatment,the serum v WF and coagulation function of the two groups were significantly improved(P<0.05).The serum v WF and PT levels in the observation group were lower than those in the control group,and the a PTT levels were significantly higher than those in the control group(P<0.05).There was no significant difference in the incidence of placental abruption between the groups.The incidence of pregnancy hypertension syndrome,fetal growth restriction and unexplained recurrent abortion in the observation group was significantly lower than that in the control group(P<0.05).There was no significant difference in the incidence of neonatal macrosomia and death between the groups,and the incidence of premature infants,asphyxia and fetal distress in the observation group was significantly lower than that in the control group(P<0.05).The total incidence of adverse reactions in the two groups was 9.68%and 8.62%,respectively,with no statistically significant difference(P>0.05).Conclusion:Aspirin has a high efficacy in the treatment of patients with gestational thrombosis,which can effectively improve serum v WF and coagulation function of patients with fewer adverse reactions and promising patient tolerance,which is worthy of promotion and application.