维生素D辅助治疗子痫前期患者的临床效果观察  

Clinical efficacy of vitamin D adjuvant therapy in the treatment of preeclampsia

作　　者：李凯 Li Kai(Department of Obstetrics,Linyi Hospital of Traditional Chinese Medicine,Linyi 272000,Shandong Province,China)

机构地区：[1]临沂市中医医院产科,临沂272000

出　　处：《中国基层医药》2024年第11期1699-1703,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的观察维生素D辅助常规抗凝、解痉治疗对子痫前期患者凝血功能、胎盘血流动力学、妊娠结局的影响。方法采用随机单盲试验,选取临沂市中医医院2021年1月至2023年1月治疗的子痫前期患者102例,采用随机数字表法分为常规治疗组(51例,硫酸镁+低分子肝素+安慰剂,持续治疗至分娩)、研究组(51例,维生素D+硫酸镁+低分子肝素,持续治疗至分娩),评估两组疗效,检测两组患者治疗前后血压、凝血功能、胎盘血流动力学指标,记录不良妊娠结局。结果研究组总有效率为92.16%(47/51),高于常规治疗组的76.47%(39/51)(χ^(2)=4.74,P<0.05)。治疗后,研究组收缩压、舒张压分别为(124.52±11.21)mmHg(1 mmHg=0.133 kPa)、(87.69±8.67)mmHg,均低于常规治疗组的(141.54±12.82)mmHg、(96.97±9.31)mmHg(t=7.14、5.21,均P<0.001);研究组活化部分凝血酶原时间、凝血酶原时间分别为(33.41±3.85)s、(14.37±2.21)s,均长于常规治疗组的(30.19±3.47)s、(12.31±2.01)s(t=-4.44、-4.93,均P<0.001);研究组脐动脉及螺旋动脉阻力指数、搏动指数均低于常规治疗组(t=4.29、8.91、6.40、12.39,均P<0.001)。研究组产后出血、新生儿窒息、早产、剖宫产发生率为11.76%(6/51)、0、5.88%(3/51)、47.06%(24/51),均低于常规治疗组的27.45%(14/51)、7.84%(4/51)、19.61%(10/51)、76.47%(39/51)(χ^(2)=3.98、4.32、4.16、9.34,均P<0.05)。结论维生素D辅助常规抗凝、解痉治疗可显著改善子痫前期患者血压、凝血功能,恢复胎盘血流动力学,降低不良妊娠结局发生率。Objective To investigate the effects of vitamin D therapy combined with conventional anticoagulant and antispasmodic therapy on coagulation function,placental hemodynamics,and pregnancy outcomes in patients with preeclampsia.Methods A randomized,single-blind trial was conducted involving 102 patients with preeclampsia treated at Linyi Hospital of Traditional Chinese Medicine from January 2021 to January 2023.These patients were randomly assigned to a conventional treatment group(n=51 patients,receiving treatment with magnesium sulfate,low molecular weight heparin,and placebo until delivery)or a study group(n=51 patients,receiving treatment with vitamin D,magnesium sulfate,and low molecular weight heparin until delivery).The efficacy of both groups was assessed,and blood pressure,coagulation function,and placental hemodynamic parameters were measured before and after treatment.Adverse pregnancy outcomes were also recorded.Results The total response rate in the study group was significantly higher than that in the conventional treatment group[92.16%(47/51)vs.76.47%(39/51),χ^(2)=4.74,P<0.05).After treatment,the systolic and diastolic blood pressures in the study group were(124.52±11.21)mmHg(1 mmHg=0.133 kPa)and(87.69±8.67)mmHg,respectively.These values were significantly lower than those in the conventional treatment group[(141.54±12.82)mmHg,(96.97±9.31)mmHg,t=7.14,5.21,both P<0.001].The activated partial thromboplastin time and prothrombin time in the study group were(33.41±3.85)seconds and(14.37±2.21)seconds,respectively.These measurements were significantly longer than those in the conventional treatment group[(30.19±3.47)seconds,(12.31±2.01)seconds,t=-4.44,-4.93,both P<0.001].The resistance index and pulsatility index of the umbilical artery and spiral artery in the study group were significantly lower than those in the conventional treatment group(t=4.29,8.91,6.40,12.39,all P<0.001).The incidences of postpartum hemorrhage,neonatal asphyxia,preterm birth,and cesarean section in the study group were 11.7

关 键 词：先兆子痫 维生素D 血流动力学 血压 部分促凝血酶原时间 凝血酶原时间 妊娠结局 随机对照试验 

分 类 号：R714.244[医药卫生—妇产科学]