低分子肝素钙联合复方丹参注射液对肾病综合征型早发型子痫前期围产结局的影响  

Effect of Low Molecular Weight Heparin Calcium Combined Compound Danshen Injection on Perinatal Outcomes of Nephrotic Syndrome Patients with Early Onset Severe Pre-eclampsia

作　　者：童重新[1] 邢小芬[1] 乔书花[1] 刘琳[1] 单玲[1] 

机构地区：[1]河北省儿童医院妇产科,石家庄050031

出　　处：《中国中西医结合杂志》2015年第8期957-961,共5页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：河北省医学研究重点课题计划(No.20100201)

摘　　要：目的观察低分子肝素钙联合复方丹参注射液对肾病综合征型早发型子痫前期围产结局的影响。方法将80例肾病综合征型早发型子痫前期患者按自愿原则分为硫酸镁组(A组,22例),硫酸镁加低分子肝素钙组(B组,19例),硫酸镁加丹参组(C组,21例),硫酸镁加低分子肝素钙加丹参组(D组,18例)。比较各组脐动脉S/D比值、羊水指数、延长孕龄时间、新生儿体重、胎盘重量、Apgar评分。结果与本组治疗前比较,四组治疗后S/D降低(P<0.05),A组羊水指数降低(P<0.05),B、C、D组羊水指数升高(P<0.05)。与A组同期比较,B、C、D组治疗后S/D降低(P<0.01,P<0.05),羊水指数升高(P<0.01,P<0.05);B、C、D组延长孕龄时间及新生儿体重升高(P<0.01,P<0.05);B、D组胎盘重量升高(P<0.05);D组1 min、5 min Apgar评分改善(P<0.05)。与B、C组同期比较,D组治疗后S/D降低(P<0.05),羊水指数升高(P<0.05)。与B组比较,C组延长孕龄时间及胎盘重量降低,D组延长孕龄时间及胎盘重量升高(P<0.05)。与C组比较,D组延长孕龄时间、胎盘重量、新生儿体重升高(P<0.05)。结论应用低分子肝素钙联合复方丹参注射液治疗肾病综合征型早发型子痫前期可延长孕龄,明显改善围产结局,效果优于单独使用。Objective To observe the effect of low molecular weight heparin calcium （LMWHC） combined Compound Danshen Injection （DI） on nephrotic syndrome patients with early onset severe preeclampsia. Methods Totally 80 nephrotic syndrome patients with early onset severe pre-eclampsia were randomly assigned to four groups voluntarily, i.e., Group A （22 cases, treated by magnesium sulfate）, B （19 cases, treated by magnesium sulfate plus LMWHC）, C （21 cases, magnesium sulfate plus DI）, D （18 cases, magnesium sulfate plus LMWHC and DI）. Umbilical arterial S/D ratios, amniotic fluid index （AFI）, prolonged gestational age, placenta weight, neonatal weight, and Apgar score were compared among the four groups. Results Compared with before treatment in the same group, umbilical arterial S/ D ratios decreased in the four groups （P 〈0.05）. AFI decreased in Group A, while it increased in Group B, C, and D （P 〈0.05）. Compared with Group A at the same time point, umbilical arterial S/D ratios decreased, and AFI increased in Group B, C, and D （P 〈0.01, P 〈0.05）. Prolonged gestational age and neonatal weight were increased in Group B, C, and D （P 〈0.01, P 〈0.05）. Placenta weight were increased in Group B and D （P 〈0.05）.Apgar scores at 1 and 5 min were improved in Group D （P 〈0.05）. Compared with Group B and C at the same time point, umbilical arterial S/D ratios decreased, and AFI increased in Group D （P 〈0.05）. Compared with Group B, prolonged gestational age and placenta weight were decreased in Group C, but prolonged gestational age and placenta weight were increased in Group D （P 〈0.05）. Compared with Group C, prolonged gestational age, placenta weight, and neonatal weight were increased in Group D （P 〈0.05）. Conclusion Treatment of nephrotic syndrome patients with early onset severe pre-eclampsia by LMWHC combined DI could prolong gestational ages, obviously improve prenatal outcomes, with better effect obtained than using any of them alone.

关 键 词：肾病综合征 早发型子痫前期 低分子肝素钙 丹参 硫酸镁 抗凝治疗 

分 类 号：R714.2[医药卫生—妇产科学]