低剂量阿司匹林对轻度子痫前期孕妇凝血功能及血清IL-6、TNF-α、COX-2、TXA2水平的影响  

Effect of low-dose aspirin on coagulation function and serum levels of IL-6,TNF-α,COX-2 and TXA2 in pregnant women with mild preeclampsia

作　　者：冯小丹 单委 FENG Xiaodan;SHAN Wei(Department of Obstetrics and Gynecology,Affiliated Maternity and Child Health Care Hospital of Nantong University,Nantong Jiangsu 226001,China)

机构地区：[1]南通大学附属妇幼保健院妇产科,江苏南通226001

出　　处：《新疆医科大学学报》2022年第8期863-866,879,共5页Journal of Xinjiang Medical University

摘　　要：目的探讨低剂量阿司匹林对轻度子痫前期(PE)孕妇凝血功能及血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、环氧酶2(COX-2)、血栓素A2(TXA2)水平的影响。方法选取轻度PE孕妇112例为研究对象,随机分成两组,每组各56例,对照组以传统的硫酸镁治疗,研究组给予钙剂联合低剂量的肠溶阿司匹林治疗。观察两组患者治疗后临床疗效,比较治疗前后凝血功能及血清IL-6、TNF-α、COX-2、TXA2水平。结果研究组总有效率为94.64%,对照组为82.14%,研究组总有效率高于对照组(χ^(2)=4.264,P=0.039)。治疗后,研究组收缩压、舒张压、24 h蛋白尿改善优于对照组[(132.50±9.30)mmHg vs(137.20±9.60)mmHg,(84.70±7.70)mmHg vs(89.40±7.40)mmHg,(1.50±0.20)g/24 h vs(1.77±0.16)g/24 h],差异有统计学意义(t=3.293、2.631、7.888,P均<0.01)。治疗后,研究组活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)高于对照组[(29.27±5.21)s vs(26.35±5.42)s,(11.39±1.28)s vs(10.14±1.32)s],纤维蛋白原(Fib)、凝血酶原活动度(PTA)低于对照组[(3.78±0.57)g/L vs(5.15±0.43)g/L,(102.57±10.20)%vs(133.44±3.27)%],差异有统计学意义(t=-2.907~21.567,P均<0.01)。治疗后,研究组血清中IL-6、TNF-α、COX-2、TXA2水平均低对照组[(21.04±4.11)ng/L vs(28.26±6.53)ng/L,(1.58±0.07)mg/L vs(2.17±0.09)mg/L,(55.46±7.72)μg/L vs(93.25±8.03)μg/L,(120.29±11.07)μg/L vs(170.34±15.89)μg/L],差异有统计学意义(t=7.002~19.340,P均<0.01)。结论低剂量阿司匹林治疗轻度PE具有较好的临床疗效,能够改善患者的血液系统高凝状态,降低诸多炎症介质的表达水平。Objective To investigate the effects of low-dose aspirin on coagulation function,serum interleukin-6(IL-6),tumor necrosis factor(TNF-α),cyclooxygenase-2(COX-2)and thromboxane A2(TXA2)in patients with mild pre⁃eclampsia(PE).Methods 112 pregnant women with mild PE were randomly divided into two groups,56 cases in each group.The control group was treated with traditional magnesium sulfate,and the study group was treated with calcium combined with low-dose aspirin.The clinical effects of the two groups were observed,The coagulation function,serum levels of IL-6,TNF-α,COX-2 and TXA2 were compared before and after treatment.Results The total effective rate was 94.64%in the study group and 82.14%in the control group(χ^(2)=4.264,P=0.039)。After treatment,the improve⁃ment of systolic blood pressure,diastolic blood pressure and 24-hour proteinuria in the study group was better than that in the control group[(132.50±9.30)mmHg vs(137.20±9.60)mmHg,(84.70±7.70)mmHg vs(89.40±7.40)mmHg,(1.50±0.20)g/24 h vs(1.77±0.16)g/24 h],The difference was statistically significant(t=3.293,2.631,7.888,P<0.01).Af⁃ter treatment,APTT and PT in the study group were higher than those in the control group[(29.27±5.21)s vs(26.35±5.42)s,(11.39±1.28)s vs(10.14±1.32)s],FIB and PTA were lower than those in the control group[(3.78±0.57)g/L vs(5.15±0.43)g/L,(102.57±10.20)%vs(133.44±3.27)%],The difference was statistically significant(t=-2.907~21.567,P<0.01).After treatment,the levels of IL-6 and TNF-αwere higher in the study group than that in the control group,The levels of COX-2 and TXA2 in the study group were lower than those in the control group[(21.04±4.11)ng/L vs(28.26±6.53)ng/L,(1.58±0.07)mg/L vs(2.17±0.09)mg/L,(55.46±7.72)μg/L vs(93.25±8.03)μg/L,(120.29±11.07)μg/L vs(170.34±15.89)μg/L],The difference was statistically significant(t=7.002~19.340,P<0.01).Conclusion LDA has good clinical effect in the treatment of mild PE,which can improve the hypercoagulable state of blood system and reduce the expression of man

关 键 词：阿司匹林 子痫前期 凝血功能 环氧酶2 血栓素A2 

分 类 号：R714.2[医药卫生—妇产科学]