丹参、维生素C、E对孕妇凝血指标的影响  

The influence to the coagulation indexes of pregnant women with Salvia Miltiorrhiza L,vitamin C and vitamin E

作　　者：杨怡珂[1] 林建华[1] 林其德[1] 张为远[2] 

机构地区：[1]上海交通大学医学院附属仁济医院妇产科,上海200127 [2]首都医科大学附属北京妇产医院

出　　处：《现代妇产科进展》2009年第9期659-663,共5页Progress in Obstetrics and Gynecology

基　　金：国家十五科技攻关项目<妊娠高血压疾病与凝血相关并发症的防治研究>(No:2004BA720A06-01);上海市教委重点学科资助项目

摘　　要：目的:探讨孕产妇预防性用药(维生素C、E、丹参)对其凝血指标的影响。方法:选择2005年4月～2006年7月上海、北京、江苏、四川等11省市24家医院4814例孕妇,随机分为Vit C+Vit E组(1407例)和非Vit C+Vit E组(3407例),在孕中期(孕20～24周)检测血凝指标,对高凝倾向者予以或不予以丹参。将孕妇总体分为药物组[应用维生素和(或)丹参1607例]与对照组(未用任何药物3207例),序贯性监测孕妇的出凝血指标(FIB、PT、APTT、TT、INR)。结果:(1)总体研究对象抑或药物组或对照组,随着孕周增加,FIB逐渐升高,PT、APTT、INR逐渐降低,TT有上升趋势;(2)对照组孕中晚期各项检测指标对比可见,孕晚-中期FIB差值显著升高(P<0.01),APTT、INR差值均显著降低(P<0.01),TT差值降低(P<0.05),PT差值无显著差异(P>0.05)。药物组孕中晚期各项检测指标对比可见,孕晚-中期FIB差值显著升高(P<0.01),INR差值显著降低(P<0.01),PT、APTT、TT差值均无显著差异;(3)药物组与对照组各项检测指标差值对比可见,除PT两组间差值无差异(P>0.05)外,药物组FIB、APTT、TT的差值均小于对照组(P<0.05);(4)3组不同药物之间对比,丹参+维生素组除FIB显著升高(P<0.01)外,PT、APTT、TT、INR均无显著改变(P>0.05)。而维生素组和丹参组的各项检测指标均无显著改变(P>0.05)。差值对比可见,仅丹参+维生素组FIB的差值明显大于维生素组和丹参组(Snk不同),其余指标的差值无显著差异(Snk均为A)。结论:随着孕周增加,药物组和对照组孕妇血液系统均逐渐处于高凝状态。单独或联合应用丹参和维生素均可缓解孕妇的高凝状态,且3组药物间的疗效相同。Objective：To explore the change of the coagulation indexes of pregnant women, who receive medicines （ Vitamin C, Vitamin E, Salvia Mihiorrhiza L ： SML） preventively. Method：From April 2005 to July 2006,4814 pregnant women from 24 national wide cooperative hospitals were involved in this prospective research project. The participants were randomly at first divided into Vitamin C＋Vitamin E group （1407 cases） and non-Vitamin C＋Vitamin E group （3407 cases）, in the mid-term of pregnancy （20 - 24 weeks）, testing the coagulation indexes, the pregnant women who had hypercoagulable trend were gave SML or not. So all of the partieipants were divided into medicines group （with administration of vitamins and/or SML, 1607cases） and control group（without any medicine given,3207cases）. Every participant was under monitoring for the coagulation tests （ FIB, PT, APTT, TT and INR）. Results： （ 1 ） Regardless of all the participants or the medicines group or the control group, with the pregnancy progressing, FIB elevated gradually, PT, APTT, INR reduced gradually and TT had the trend of elevation. （2）In the control group, comparing the indexes between mid and late term of pregnancy,the FIB＇s D-value （late-term＇s index subtract mid-term＇s） elevated obviously （P〈0. 01）, the APTT＇s and INR＇s D-values reduced obviously （P〈0. 01 ）, the TT＇s D-value reduced（P〈 0.05 ） , while the PT＇s D-value had no change （P〉0.05）. In the medicines group, FIB＇s D-value ascended obviously（P〈0.01 ）,but had no difference in PT,APTT,TT. （3） Comparing the D-value between two groups, the D-values of FIB, APTT and TT （ except PT ） in medicines group were less than those in control group. （4 ） Comparing the results using the three different medicines, in SML＋Vitamin group, there had no changes in PT, APTT, TT, INR except FIB ascending obviously （P〈0.01）. In Vit group and SML group,there were no change in all indexes （P〉0.05）. Whereas,in th

关 键 词：丹参 维生素C 维生素E 抗氧化剂 妊娠高凝状态 

分 类 号：R714.14[医药卫生—妇产科学]