摘要
目的探讨高压氧联合小剂量阿司匹林治疗妊娠期高血压(孕高征)的临床疗效及对妊娠结局的影响。方法选取2021年4月至2023年9月延安市人民医院妇产科收治的99例孕高征孕妇作为研究对象。按照不同的治疗方法将99例孕妇分为对照组(n=50)和观察组(n=49)。对照组孕妇在常规治疗的基础上联合小剂量阿司匹林治疗,观察组孕妇在对照组治疗的基础上联合高压氧治疗。采用血压测量仪测量2组孕妇治疗前后收缩压(SBP)、舒张压(DBP)的变化。统计2组孕妇的临床疗效。采用全自动血生化分析仪检测24 h尿蛋白(24 hU-pro)水平,采用酶联免疫吸附法检测血浆内皮素-1(ET-1)、血管性血友病因子(vWF)水平,采用放射免疫法检测血清一氧化氮(NO)水平,采用凝固法和免疫比浊法测定血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)及纤维蛋白原(FIB)水平。统计2组孕妇不良妊娠结局和治疗过程中的不良反应。结果治疗后观察组总有效率(97.96%,48/49)明显高于对照组(84.00%,42/50),差异有统计学意义(χ^(2)=4.268,P=0.039)。与治疗前相比,2组孕妇治疗后DBP、SBP、24 h U-pro、ET-1、vWF均明显降低,且治疗后观察组均明显低于对照组(均P<0.01)。与治疗前相比,2组孕妇治疗后NO水平均明显升高,且治疗后观察组明显高于对照组(P<0.01)。与治疗前相比,2组孕妇治疗后PT、APTT、TT均明显延长,FIB水平明显降低,且治疗后观察组PT、APTT、TT均明显长于对照组,FIB水平明显低于对照组(均P<0.01)。观察组孕妇不良妊娠结局发生率(4.08%,2/49)明显低于对照组(18.00%,9/50),差异有统计学意义(χ^(2)=4.854,P=0.028)。观察组孕妇不良反应发生率(6.12%,3/49)与对照组(4.00%,2/50)比较,差异无统计学意义(χ^(2)=0.011,P=0.982)。结论高压氧联合小剂量阿司匹林治疗孕高征孕妇疗效较好,可有效降低孕妇血压和24 h U-pro水平,改善血管内皮功能和凝血功能,且不良妊娠结局发生率较低,临床安全性较高。
Objective:To investigate the clinical efficacy of hyperbaric oxygen(HBO)combined with low-dose aspirin in the treatment of gestational hypertension and its impact on pregnancy outcomes.Methods:A total of 99 pregnant women with gestational hypertension admitted to the Department of Obstetrics and Gynecology at Yan’an People’s Hospital from April 2021 to September 2023 were enrolled and divided into a control group(n=50)and an observation group(n=49)based on different treatment methods.The control group received conventional treatment combined with low-dose aspirin,while the observation group received additional HBO therapy.Systolic blood pressure(SBP)and diastolic blood pressure(DBP)were measured using a U30 sphygmomanometer,and clinical efficacy was evaluated.A fully automated biochemical analyzer was used to measure 24-hour urinary protein(24 hU-pro)levels.Plasma endothelin-1(ET-1)and von Willebrand factor(vWF)levels were detected by enzyme-linked immunosorbent assay,serum nitric oxide(NO)by radioimmunoassay,and prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),and fibrinogen(FIB)levels by coagulation and immunoturbidimetric methods.Adverse pregnancy outcomes and treatment-related adverse reactions were recorded.Results:After treatment,the total effective rate in the observation group(97.96%,48/49)was significantly higher than that in the control group(84.00%,42/50)(χ^(2)=4.268,P=0.039).Compared with pretreatment levels,both groups showed significant reductions in DBP,SBP,24 hU-pro,ET-1,vWF,and NO,with the observation group exhibiting lower levels than the control group(all P<0.01).Compared with pre-treatment levels,the NO levels in both groups of pregnant women were significantly increased after treatment,with the observation group showing markedly higher levels than the control group(P<0.01).PT,APTT,and TT were significantly prolonged,and FIB levels were significantly reduced in both groups after treatment,with the observation group showing greater improvements than the control group(all P<0.01).The incidence of adverse pregnancy outcomes in the observation group(4.08%,2/49)was significantly lower than that in the control group(18.00%,9/50)(χ^(2)=4.854,P=0.028).No significant difference was observed in adverse reaction rates between the observation group(6.12%,3/49)and the control group(4.00%,2/50)(χ^(2)=0.011,P=0.982).Conclusion:HBO combined with low-dose aspirin demonstrates superior efficacy in treating gestational hypertension,effectively reducing blood pressure and 24 h urinary protein levels,improving vascular endothelial and coagulation functions,and lowering the incidence of adverse pregnancy outcomes with high clinical safety.
作者
马园园
王慧玲
梁娜
Ma Yuanyuan;Wang Huiling;Liang Na(Department of Obstetrics and Gynecology,Yan'an People's Hospital,Yan'an 716000,China)
出处
《中华航海医学与高气压医学杂志》
2025年第7期710-714,共5页
Chinese Journal of Nautical Medicine and Hyperbaric Medicine
基金
中华国际科学交流基金会检验检测科技专项基金(Z2020LSXB001)
延安市科技计划资助项目(2021YF-09)。
关键词
妊娠期高血压
高压氧
阿司匹林
妊娠结局
Gestational hypertension
Hyperbaric oxygen
Aspirin
Pregnancy outcomes
