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目的探讨硫酸镁联合低分子肝素治疗早发型子痫前期的疗效及其妊娠结局。方法将50例早发型子痫前期患者分为硫酸镁治疗组(n=22)和硫酸镁联合低分子肝素治疗组(n=28),并进行病例对照分析,观察治疗前后的凝血功能、肾功能变化及妊娠结局。结果两组患者治疗后收缩压及舒张压均明显下降,但下降幅度差异无统计学意义(P>0.05)。排除治疗前凝血功能或肾功能基础值的影响,硫酸镁联合低分子肝素治疗使凝血酶原时间(PT)明显延长、凝血酶原时间国际标准化比值(PT-INR)明显增大、凝血酶时间(TT)明显延长,差异有统计学意义(P<0.05),但上述各指标改变后仍在正常范围以内。硫酸镁联合低分子肝素治疗对尿蛋白及血尿酸的减少影响更显著,差异有统计学意义(P<0.05)。两个治疗组之间的血清尿素氮和血清肌酐的变化差异无统计学意义(P>0.05)。两组之间的分娩孕周、期待治疗时间、新生儿体重及新生儿出生Apgar评分及母儿并发症发生率差异均无统计学意义(P>0.05)。结论在传统治疗的基础上加用低分子肝素辅助治疗早发型子痫前期是安全的,且可以对肾功能起到保护作用,明显减少尿蛋白量。尚未观察到低分子肝素对妊娠结局的影响。
Objective To investigate the efficacy of magnesium sulfate combined with low molecular weight heparin in the treatment of early-onset preeclampsia and its pregnancy outcome. Methods Fifty patients with early-onset preeclampsia were divided into the treatment group (n = 22) and magnesium sulfate combined with low molecular weight heparin group (n = 28), and the case-control analysis was performed to observe the coagulation function before and after treatment, Functional changes and pregnancy outcomes. Results After treatment, the systolic and diastolic blood pressures decreased significantly in both groups, but the difference was not statistically significant (P> 0.05). Excluding the effect of coagulation function or the basic value of renal function before treatment, magnesium sulfate combined with low molecular weight heparin prolonged prothrombin time (PT), PT-INR significantly increased, thrombin time (TT) was significantly longer, the difference was statistically significant (P <0.05), but the above indicators are still within the normal range after the change. Magnesium sulfate combined with low molecular weight heparin treatment of urinary protein and serum uric acid decreased more significantly, the difference was statistically significant (P <0.05). There was no significant difference in serum urea nitrogen and serum creatinine between the two treatment groups (P> 0.05). There was no significant difference in gestational age, expectant treatment time, newborn weight, newborn birth Apgar score and the incidence of maternal complications between the two groups (P> 0.05). Conclusions The addition of low molecular weight heparin to pretreatment of preeclampsia is safe on the basis of traditional treatment. It can also play a protective role on renal function and significantly reduce the amount of urinary protein. The effect of low molecular weight heparin on pregnancy outcome has not been observed.