小剂量阿司匹林联合低分子肝素钙对早发型PE患者子宫动脉血流、脂代谢、凝血功能及妊娠结局影响  

Effects of low-dose aspirin combined with low molecular weight heparin calcium for treating pregnant women with early-onset preeclampsia on their uterine arterial blood flow,lipid metabolism,coagulation function,and pregnancy outcomes

作　　者：郑路路 杨丽萍[1] 马建彩[1] 李瑞雪 ZHENG Lulu;YANG Liping;MA Jiancai;LI Ruixue(Handan Central Hospital,Hebei Province,056000)

机构地区：[1]河北省邯郸市中心医院,056000

出　　处：《中国计划生育学杂志》2023年第11期2615-2620,共6页Chinese Journal of Family Planning

基　　金：河北省卫健委重点科技研究计划项目(20220553)。

摘　　要：目的:探究小剂量阿司匹林联合低分子肝素钙治疗早发型子痫前期(PE)对患者子宫动脉血流、脂代谢、凝血功能及妊娠结局的影响。方法:选取2021年1月-2022年1月本院确诊治疗的早发型PE患者110例,随机数字表法分为联合组(n=55)和对照组(n=55),均予常规治疗并加予小剂量阿司匹林,治疗组加用低分子肝素钙注射,治疗7d,比较两组子宫血供[子宫动脉阻力指数(RI)、搏动指数(PI)]情况,血清妊娠相关血浆蛋白A(PAPP-A)、血清胎盘生长因子(PLGF)水平,脂代谢指标[血清总胆固醇(TC)、甘油三酯(TG)、载脂蛋白AI(ApoAI)、载脂蛋白B(ApoB)]及凝血功能[凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、D-二聚体(DD)、纤维蛋白原(FIB)],随访妊娠结局,统计治疗期间不良反应。结果:治疗后两组RI和PI均较治疗前降低且联合组(0.47±0.06、0.72±0.17)低于对照组(0.51±0.07、0.81±0.15),两组血清PAPP-A、PLGF均较治疗前升高且联合组(47.29±12.37 ng/ml、25.67±8.46μg/L)高于对照组(41.73±14.57 ng/ml、22.45±8.17μg/L),两组TC、TG、ApoB均较治疗前降低,ApoAI较治疗前升高,两组血清PT、APTT均较治疗前升高,DD、FIB降低,且联合组变化幅度大于对照组(均P<0.05);联合组终止妊娠时孕周(36.27±1.72周)、Apgar评分(8.32±0.87分)均高于对照组(35.61±1.24周、7.86±0.79分),胎儿宫内窘迫率(5.5%)、胎盘早剥率(3.6%)均小于对照组(18.2%、14.6%)(均P<0.05),两组羊水过少率、产后出血率及总不良反应无差异(P>0.05)。结论:小剂量阿司匹林联合低分子肝素钙治疗早发型PE患者,可更好地改善患者子宫动脉血流动力学及脂代谢和凝血功能紊乱,妊娠结局获益更好。Objective:To explore the effects of low-dose aspirin combined with low molecular weight heparin calcium for treating pregnant women with early-onset preeclampsia(PE)on their uterine arterial blood flow,lipid metabolism,coagulation function,and pregnancy outcomes.Methods:110 pregnant women with early-onset PE were selected and were divided into two groups(55 cases in each group)by random number table method between January 2021 and January 2022.The women in both groups were given routine treatment,and the women in the control group were given low-dose aspirin for 7 days of treatment additionally and the women in the treatment group were given low-dose aspirin combined with low molecular weight heparin calcium injection for 7 days of treatment additionally.The situation of uterine blood supply,such as uterine artery resistance index(RI)and pulsatility index(PI),the levels of serum pregnancy-associated plasma protein A(PAPP-A)and serum placental growth factor(PLGF),and lipid metabolism indicators,such as serum total cholesterol(TC),triglyceride(TG),apolipoprotein AI(ApoAI),and apolipoprotein B(ApoB),and the values of coagulation function,such as prothrombin time(PT),activated partial thromboplastin time(APTT),Ddimer(D-D),and fibrinogen(FIB)of the women were compared between the two groups.The pregnancy outcomes of the women in the two groups were followed up.The adverse reactions of the women in the two groups during treatment were counted.Results:The values of RI and PI of the women in the two groups after treatment had decreased significantly,and which(0.47±0.06and 0.72±0.17)of the women in the treatment group were significantly lower than those(0.51±0.07and 0.81±0.15)of the women in the control group.The levels of serum PAPP-A and PLGF of the women in the two groups after treatment had increased significantly,and which(47.29±12.37ng/ml and 25.67±8.46μg/L)of the women in the treatment group were significantly higher than those(41.73±14.57ng/ml and 22.45±8.17μg/L)of the women in the control group.The leve

关 键 词：早发型子痫前期 小剂量阿司匹林 低分子肝素钙 子宫动脉血流 妊娠相关血浆蛋白A 胎盘生长因子 血脂 凝血功能 妊娠结局 

分 类 号：R714.244[医药卫生—妇产科学]