摘要
目的探究依诺肝素联合阿司匹林对既往妊娠高血压疾病(HDCP)和胎儿生长受限(FGR)孕妇的应用价值。方法选择2010年1月至2017年12月北京航天中心医院妇产科分娩的既往有HDCP和FGR病史的124例孕妇为研究对象。按照治疗方式,将124例孕妇分为联合治疗组和阿司匹林组,每组62例。联合治疗组的孕妇口服阿司匹林(100mg,qd)联合依诺肝素皮下注射(4000IU,qd)治疗,阿司匹林组孕妇口服阿司匹林(100mg,qd)治疗,比较两组孕妇的妊娠情况、分娩情况、用药前后IL-6、TNF-α和IFN-γ水平的变化和新生儿情况。结果两组孕妇HELLP综合征、妊娠期糖尿病及分娩前出血率比较,其差异均无统计学意义(均P>0.05);联合治疗组孕妇HDCP和FGR总发生率均明显低于阿司匹林组孕妇,其差异均具有统计学意义(P<0.05)。两组孕妇的分娩孕周数和产后出血量比较,其差异均无统计学意义(均P>0.05);联合治疗组孕妇引产、剖宫产和早产发生率均明显低于阿司匹林组孕妇,其差异均具有统计学意义(P<0.05)。用药前,两组孕妇的IL-6、TNF-α和IFN-γ水平比较,其差异均无统计学意义(均P>0.05);用药10W后,两组患者的IL-6、TNF-α和IFN-γ水平均有明显降低,且联合治疗组孕妇的各项指标均显著低于阿司匹林组孕妇,其差异均具有统计学意义(均P<0.05)。两组孕妇所产新生儿的Apgar评分、新生儿死亡率和并发症发生率比较,其差异无统计学意义(均P>0.05),联合治疗组NICU收治率和吸氧率均明显低于阿司匹林组,新生儿体重明显高于阿司匹林组,其差异均具有统计学意义(均P<0.05)。结论依诺肝素联合阿司匹林能够有效减少高危孕妇HDCP和FGR的再发率,降低母体炎症因子水平,改善分娩结局和新生儿健康状况。
Objective To explore the application value of enoxaparin combined with aspirin in patients with previous hypertensive disorder complicating pregnancy(HDCP) and fetal growth restriction(FGR). Methods From January 2010 to December 2017, 124 puerperas with history of HDCP and FGR who delivered in the gynaecology and obstetrics department of Beijing Aerospace Center Hospital were divided into combination therapy group(62 cases) and aspirin group(62 cases) and were given aspirin(100 mg, qd) combined with enoxaparin(4000 IU, qd) and oral aspirin(100 mg, qd) respectively. The pregnancy situation, the delivery situation, changes in the level of IL-6, TNF-α and IFN-γ before and after drug use and newborn information were compared between the two groups. Results No significant difference in HELLP syndrome, gestational diabetes and antepartum hemorrhage was found between the two groups(all P>0.05), and the incidence rates of HDCP and FGR were significantly lower in combination therapy group than those in aspirin group(P<0.05). No significant difference in gestational age at delivery and postpartum hemorrhage was found between the two groups(all P>0.05), but the incidence rates of induction, cesarean delivery and preterm birth were significantly lower in combination therapy group than those in aspirin group(P<0.05). No significant difference was found in the level of IL-6, TNF-α and IFN-γ before treatment(all P>0.05). After 10 weeks of treatment, the levels of IL-6, TNF-α and IFN-γ in both groups decreased when compared with those before treatment, while those indexes in combination therapy group were significantly lower than those in the aspirin group(all P<0.05). There was no significant difference in Apgar score, newborn death rate and incidence of complication between the two group(all P>0.05), while the rates of admitted to NICU and oxygen used were significantly lower, and the newborn weight was obviously higher in combination therapy group, all with statistically significant differences(all P<0.05). Conclusions Enoxaparin combined with aspirin can decrease the recurrence rate of HDCP and FGR, reduce level of maternal inflammation and improve delivery outcomes and newborn health obviously.
作者
高丽欣
李烁
王丛
GAO Lixin;LI Shuo;WANG Cong(Department of Obstetrics and Gynecology,Beijing Aerospace Center Hospital,Beijing 100049,China;Department of Physiology andPathophysiology,Peking University Health Science Center,Beijing 100191,China)
出处
《中国性科学》
2020年第1期52-56,共5页
Chinese Journal of Human Sexuality
关键词
依诺肝素
阿司匹林
妊娠高血压疾病
胎儿生长受限
应用价值
Enoxaparin
Aspirin
Hypertensive disorder complicating pregnancy (HDCP)
Fetal growth restriction (FGR)
Application value
