低分子肝素联合硫酸镁对于早发型重度子痫前期患者尿蛋白与妊娠结局的影响

The effect of low molecular weight heparin combined with magnesium sulfate on urinary protein and pregnancy outcomes in patients with early-onset severe preeclampsia

杨文祎 ¹居晓庆¹

扫码查看

作者信息

1. 南京医科大学附属苏州医院妇产科,江苏苏州 215002
折叠

摘要

目的分析低分子肝素联合硫酸镁对于早发型重度子痫前期患者尿蛋白与妊娠结局的影响.方法选取2020年1月～2023年1月间南京医科大学附属苏州医院产科收治的158例早发型重度子痫前期患者,随机分为研究组和对照组各79例,对照组使用硫酸镁治疗,研究组使用低分子肝素+硫酸镁治疗,4周后对比两组的治疗效果.结果从血压水平来看,对照组患者的收缩压(systolic blood pressure,SBP)为(139.60±8.46)mmHg、舒张压(diastolic blood pressure,DBP)为(93.54± 5.19)mmHg,研究组分别为(125.34±7.51)mmHg、(84.26±4.20)mmHg,均显著低于对照组(P＜0.05).从凝血功能指标来看,对照组患者的血浆凝血酶原时间(PT)为(10.34±0.94)s、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)为(22.79±1.96)s,研究组分别为(12.09±1.07)s、(25.84±2.27)s,均显著长于对照组(P＜0.05);对照组患者的纤维蛋白原(FIB)为(3.64±0.34)g/L、D-二聚体(D-D)为(0.95±0.09)μg/ml,研究组分别为(3.15±0.29)g/L、(0.83±0.08)μg/ml,均显著低于对照组(P＜0.05).从子宫螺旋动脉血流动力学指标来看,对照组患者的收缩期最大血液速度(PSV)为(34.12±3.07)cm/s、舒张末期速度(EDV)为(28.72±2.43)cm/s,研究组分别为(38.79±3.45)cm/s、(33.14±2.95)cm/s,均显著高于对照组(P＜0.05);对照组患者的血流速度峰谷比(S/D)为(2.34± 0.46)、血流搏动指数(PI)为(0.50±0.04)、血流阻力指数(RI)为(0.48±0.44),研究组分别为(2.06± 0.38)、(0.42±0.03)、(0.41±0.33),均显著低于对照组(P＜0.05).从肾脏、心脏损伤来看,对照组患者的 24h 尿蛋白水平(24hrUprV)水平为(1.53±0.14)g、B 型钠尿肽(BNP)为(341.92±31.25)pg/L,研究组分别为(1.24±0.11)g、(253.68±22.84)pg/L,显著低于对照组(P＜0.05).从早产儿、胎儿窘迫、宫缩乏力、新生儿窒息、产后出血等情况来看,对照组的不良结局发生率为84.81％(67/79),研究组为53.16％(42/79),显著低于对照组(P＜0.05).结论低分子肝素联合硫酸镁治疗子痫前期,有利于改善血压指标、凝血功能指标和血流动力学指标,减轻肾脏和心脏损伤,降低不良结局发生率,是一种高效、安全的用药方案.

Abstract

Objective To analyze the effect of low molecular weight heparin combined with magnesium sulfate on urinary protein and pregnancy outcomes in patients with early-onset severe preeclampsia.Methods 158 patients were randomly divided into two groups.The control group was treated with magnesium sulfate,while the study group was treated with low molecular weight heparin and magnesium sulfate.After 4 weeks,the treatment effects of the two groups were compared.Results The SBP and DBP of the control group were(139.60±8.46)mmHg and(93.54±5.19)mmHg,respectively.The study group was(125.34±7.51)mmHg and(84.26±4.20)mmHg,significantly lower than the control group(P＜0.05).The PT and APTT of the control group were(10.34±0.94)s and(22.79±1.96)s,respectively.The study group was(12.09±1.07)s and(25.84±2.27)s,which were significantly longer than the control group(P＜0.05);The FIB of the control group was(3.64±0.34)g/L,and the D-D was(0.95±0.09)p G/ml,the study groups were(3.15±0.29)g/L and(0.83±0.08)respectively p G/ml,significantly lower than the control group(P＜0.05).The PSV and EDV of the control group were(34.12±3.07)cm/s and(28.72±2.43)cm/s,respectively.The study group had(38.79± 3.45)cm/s and(33.14±2.95)cm/s,which were significantly higher than the control group(P＜0.05);The S/D of the control group was(2.34±0.46),PI was(0.50±0.04),and RI was(0.48±0.44).The study group was(2.06±0.38),(0.42±0.03),and(0.41±0.33),respectively,significantly lower than the control group(P＜0.05).The 24hrUprV and BNP of the control group were(1.53±0.14)g and(341.92±31.25)pg/L,respectively.The study group had(1.24±0.11)g and(253.68±22.84)pg/L,which were significantly lower than the control group(P＜0.05).The incidence of adverse outcomes was 84.81％(67/79)in the control group and 53.16％(42/79)in the study group,significantly lower than the control group(P＜0.05).Conclusion The combination of low molecular weight heparin and magnesium sulfate in the treatment of preeclampsia is beneficial for improving blood pressure,coagulation function,and hemodynamic indicators,reducing kidney and heart damage,and reducing the incidence of adverse outcomes.It is an efficient and safe medication regimen.

关键词

低分子肝素/硫酸镁/早发型重度子痫前期/尿蛋白/妊娠结局

Key words

Low molecular weight heparin/Magnesium sulfate/Early onset severe preeclampsia/Urinary protein/pregnancy outcome

引用本文复制引用

出版年

2024

中国产前诊断杂志(电子版)

人民卫生出版社

中国产前诊断杂志(电子版)

影响因子：0.483

ISSN：1674-7399

参考文献量10

段落导航