PE高危孕妇LDA抗凝预后与用药剂量及时机之间的相关性研究  

Correlation between LDA Anticoagulant Prognosis and Dosage and Timing of Medication in PE High-risk Pregnant Women

作　　者：刘晓兰 吴侃倪 梁金燕 LIU Xiao-lan;WU Kan-ni;LIANG Jin-yan(Department of Gynaecology and Obstetrics,Shaoguan City Maternal and Child Health Hospital,Shaoguan 512000,Guangdong Province,China)

机构地区：[1]韶关市妇幼保健院妇产科,广东韶关512000

出　　处：《罕少疾病杂志》2024年第12期129-131,共3页Journal of Rare and Uncommon Diseases

基　　金：韶关市科技计划项目(230330098033787)。

摘　　要：目的探究先兆子痫(PE)高危孕妇小剂量阿司匹林(LDA)抗凝预后与用药剂量及时机之间的相关性。方法将该院2023年1月至2024年3月于我院规律产检直至分娩的180例PE高危孕产妇作为研究对象,随机分为6组,孕12周治疗组(A组)与孕16周治疗组(B组),其中A组分为小剂量(75mg)阿司匹林口服组(A1组)、中剂量(100mg)阿司匹林口服组(A2组)、大剂量(125mg)阿司匹林口服组(A3组);B组同理分为B1、B2、B3组。观察直至分娩结束。比较两组的子痫前期发病状况、胎盘早剥、产后出血等妊娠结局和不良反应,以及新生儿出生的体重、胎儿生长受限(FGR)、新生儿窒息等发生状况,以探索小剂量阿司匹林预防子痫前期的应用时间、使用剂量,旨在分析小剂量阿司匹林预防子痫前期。结果A3组子痫前期发生率3.33%低于A2、B1、B2组16.67%、10.00%、20.00%(P>0.05),A3组子痫前期发生率3.33%低于A1、B3组26.67%、26.67%(P<0.05)。治疗后,A3组血脂代谢指标均优于A1、A2、B1、B2、B3组(P<0.05)。A3组孕妇母婴并发症发生率3.33%低于A2组13.33%(P>0.05),A1、B1、B2、B3组孕妇母婴并发症发生率36.67%、30.00%、26.67%、33.33%高于A3组3.33%(P<0.05)。结论PE高危孕妇于孕12周开始口服LDA(125mg),可有效改善其凝血功能,降低PE发生率,改善母婴结局,值得临床推广。Objective To explore the correlation between the anticoagulant prognosis of low-dose aspirin(LDA)in pregnant women at high risk of preeclampsia(PE)and the dose and timing.Methods A total of 180 women with high risk of PE who were regularly examined in our hospital until delivery from January 2023 to March 2024 were randomly divided into 6 groups:12-week gestation treatment group(group A)and 16-week gestation treatment group(group B).Group A was divided into low-dose(75mg)aspirin oral group(A1 group),medium-dose(100mg)aspirin oral group(A2 group)and high-dose(125mg)aspirin oral group(A3 group).Group B is similarly divided into groups B1,B2 and B3.Observe until the end of labor.The incidence of preeclampsia,placental abruption,postpartum hemorrhage and other pregnancy outcomes and adverse reactions,as well as birth weight,fetal growth restriction(FGR),neonatal asphyxia and other occurrence conditions of the two groups were compared to explore the application time and dosage of low-dose aspirin to prevent preeclampsia,aiming to analyze the prevention of preeclampsia by low-dose aspirin.Results The incidence of preeclampsia in group A3 was 3.33% lower than that in groups A2,B1 and B2,16.67%,10.00% and 20.00%(P>0.05),and the incidence of preeclampsia in group A3 was 3.33% lower than that in groups A1 and B3,26.67% and 26.67%(P<0.05).After treatment,the lipid metabolism indexes in group A3 were better than those in groups A1,A2,B1,B2 and B3(P<0.05).The incidence of maternal and infant complications in A3 group was 3.33% lower than that in A2 group(13.33%,P>0.05),and the incidence of maternal and infant complications in A1,B1,B2,B3 groups was 36.67%,30.00%,26.67%,33.33% higher than that in A3 group(3.33%,P<0.05).Conclusion The oral administration of LDA(125mg)at 12 weeks of gestation can effectively improve the coagulation function,reduce the incidence of PE,and improve the outcome of the mother and child,which is worthy of clinical promotion.

关 键 词：先兆子痫高危孕妇 小剂量阿司匹林 用药剂量 用药时机 

分 类 号：R714.244[医药卫生—妇产科学]