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目的探讨小剂量阿司匹林在子痫前期高危人群中的预防价值。方法 118例子痫前期高危人群随机分成两组,研究组58例,孕13~16周开始口服阿司匹林75 mg/d,睡前顿服至分娩;对照组60例,不服用任何药物。比较两组妇女的子痫前期、早产、胎盘早剥、胎儿生长受限、围产儿死亡、产后出血、阴道分娩及自然流产发生情况。结果两组间高危因素的分布差异无统计学意义(P>0.05);两组间年龄、孕产次比较差异无统计学意义(P>0.05);孕期口服阿司匹林主要分布在孕13、14周。研究组流产、子痫前期(轻度、重度)、早产、胎儿生长受限发生率较对照组低,差异有统计学意义(P<0.05);而胎盘早剥、围生儿死亡、阴道分娩及产后出血发生率与对照组相比,差异无统计学意义(P>0.05);研究组分娩孕周明显大于对照组,差异有统计学意义(P<0.05)。结论早孕期(孕龄≤16孕周)预防性应用小剂量阿司匹林,可显著降低子痫前期及胎儿生长受限发生风险。且对子痫前期高危人群中子痫前期、早产、胎儿生长受限具有预防作用,并不增加产后出血、胎盘早剥、自然流产及围生儿死亡等的发生风险。
Objective To investigate the preventive value of low dose aspirin in high risk population of preeclampsia. Methods A total of 118 high risk preeclampsia patients were randomly divided into two groups. The study group consisted of 58 patients who started oral aspirin 75 mg / d from 13 to 16 weeks of gestation. Their bedtime was from Dayton to delivery. In the control group, 60 patients were given no medication. The incidences of preeclampsia, premature labor, placental abruption, fetal growth restriction, perinatal death, postpartum hemorrhage, vaginal delivery and spontaneous abortion were compared between the two groups. Results There was no significant difference in the distribution of risk factors between the two groups (P> 0.05). There was no significant difference in age and motherhood between the two groups (P> 0.05). The oral aspirin during pregnancy was mainly distributed in pregnant 13 and 14 weeks . The incidence of miscarriage, preeclampsia (mild and severe), premature birth and fetal growth restriction in the study group were lower than those in the control group (P <0.05). However, the incidence of abortion, perinatal death and vaginal delivery And the incidence of postpartum hemorrhage compared with the control group, the difference was not statistically significant (P> 0.05); gestational age of the study group was significantly larger than the control group, the difference was statistically significant (P <0.05). Conclusions Early prophylaxis with small doses of aspirin in gestational age ≤16 gestational weeks can significantly reduce the risk of preeclampsia and fetal growth restriction. It also has the preventive effect on preeclampsia, premature delivery and fetal growth restriction in the high risk population of preeclampsia without increasing the risk of postpartum hemorrhage, placental abruption, spontaneous abortion and perinatal death.