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目的:探讨小剂量阿司匹林对高危孕妇子痫前期及妊娠诱发的高血压综合征的预防作用。方法:将242例存在子痫前期高危因素暴露的孕13~16周的妇女随机分成阿司匹林处理组(n=120,睡前口服75 mg阿司匹林至分娩)和对照组(n=122,安慰剂替代阿司匹林),随访至妊娠结束后2周,记录子痫及妊娠高血压综合征的发生率。结果:本研究中共失访5例,其中阿司匹林组2例,对照组3例。子痫前期的发生率,阿司匹林组低于对照组(18.6%vs 52.9%),其中轻度子痫前期、早发子痫前期、严重子痫前期的发生率阿司匹林组(11.0%、3.4%、4.2%)均低于对照组(26.9%、12.6%、13.4%)。妊娠诱发高血压的发生率(4.2%vs 16.0%)、宫内发育迟缓发生率(13.6%vs 30.3%)、出生孕周<34周的孕妇比例(4.2%vs 13.4%)、37周前分娩的孕妇比例(18.6%vs 40.3%)、流产比例(2.5%vs 10.1%),阿司匹林组均低于对照组。平均出生体质量(2 890±340 g vs 2 611±479 g)、平均出生孕周(36.8±2.0 vs 35.0±3.1),阿司匹林组大于对照组(P<0.05)。阿司匹林组与对照组在新生儿围产期内死亡率(0.8%vs 1.7%)、胎盘早剥率(6.8%vs 5.0%)、阴道分娩率(43.2%vs 40.3%)之间均无统计学差异(P>0.05)。结论:睡前口服小剂量阿司匹林能使子痫前期高危孕妇受益。
Objective: To investigate the preventive effect of low dose aspirin on high risk pregnant women with preeclampsia and pregnancy induced hypertension syndrome. METHODS: Totally 242 women aged 13 to 16 weeks who were at high risk of preeclampsia were randomized to aspirin treatment (n = 120, aspirin 75 mg orally at bedtime) and control (n = 122, placebo replacement Aspirin), followed up to 2 weeks after the end of pregnancy, recording the incidence of eclampsia and pregnancy-induced hypertension syndrome. Results: A total of 5 cases were lost to follow-up in this study, including 2 as aspirin group and 3 as control group. The incidence of preeclampsia in aspirin group was lower than that in control group (18.6% vs 52.9%). The incidence of preeclampsia, preeclampsia and severe preeclampsia in aspirin group (11.0%, 3.4% 4.2%) were lower than the control group (26.9%, 12.6%, 13.4%). The incidence of pregnancy-induced hypertension (4.2% vs 16.0%), intrauterine growth retardation (13.6% vs 30.3%), gestational weeks <34 weeks of pregnant women (4.2% vs 13.4%), 37 weeks before delivery (18.6% vs 40.3%) and miscarriage (2.5% vs 10.1%) in the aspirin group were lower than those in the control group. The mean birth weight (2 890 ± 340 g vs 2 611 ± 479 g), mean gestational age at birth (36.8 ± 2.0 vs 35.0 ± 3.1), aspirin group (P <0.05). Aspirin group and control group in the neonatal perinatal mortality rate (0.8% vs 1.7%), placental abruption rate (6.8% vs 5.0%), vaginal delivery rate (43.2% vs 40.3%) between no statistical Difference (P> 0.05). Conclusion: Small doses of aspirin before bedtime can benefit pregnant women at high risk of preeclampsia.