【摘要】 目的探讨孕早期小剂量阿司匹林干预对预防子痫前期的意义。方法前瞻性地选取2016年11月至2017年10月在张家港市第一人民医院建档并定期产检的具有子痫前期高危因素的孕妇60例。采用随机数字表法将患者分为研究组和对照组,每组各30例。研究组患者于孕13～16周给予阿司匹林50～75 mg,睡前口服至孕28周;对照组患者则服用安慰剂50～75 mg,睡前口服至孕28周。比较两组患者的一般资料及产科资料(包括年龄、孕前BMI、慢性高血压、糖尿病的发生率、子痫前期家族史、葡萄胎史和产次)和主要妊娠结局(包括平均分娩孕周、剖宫产、妊娠期高血压、子痫前期、胎盘早剥、胎儿宫内生长受限、产后出血发生率、新生儿体重)。结果对照组患者平均分娩孕周(36. 1±2. 1)周显著早于研究组(37. 5±2. 4)周,研究组患者妊娠期高血压、子痫前期、胎盘早剥、胎儿宫内发育迟缓(IUGR)发生率50. 00%(15/30)、13. 33%(4/30)、0、3. 33%(1/30)显著低于对照组86. 67%(26/30)、60. 00%(18/30)、16. 67%(5/30)、33. 33%(10/30),差异具有统计学意义(P <0. 05)。两组患者产后出血、剖宫产率6. 67%(2/30)、60. 00%(18/30) vs. 26. 67%(10/30)、80. 00%(24/30)差异无统计学意义(P> 0. 05)。研究组新生儿出生体重(2 912±332) g显著高于对照组(2 643±354) g(P <0. 05)。两组患者均未发生死胎、死产、孕妇死亡等不良结局。并且,两组患者均完成用药(或安慰剂),用药期间均未发生明显的药物不良反应。结论通过孕早期对高危孕妇口服小剂量阿司匹林干预,可以降低子痫前期发生率并改善不良妊娠结局。更多还原

【Abstract】 Objective To explorte the significance of intervention with low dosage aspirin for prevention of preeclampsia in women with early pregnancy. Methods Sixty pregnant women with high risk factors were prospectively selected during November 2016 to Octorber 2017 in the prenatal clinic of this hospital. These patients were divided into study group and control group by random number table method,each group with 30 cases. Patients in study group received aspirin 50 ～ 75 mg orally for 28 weeks during 13 to 16 weeks of pregnancy,and patients in control group were given with placebo 50 ～ 75 mg orally for 28 weeks. The general and obstetric data( including age,BMI before pregnancy,incidence of chronic hypertension,diabetes mellitus,family history of preeclampsia,history of hydatidiform mole and parity) and major pregnancy outcomes( including mean gestational age,cesarean section,gestational hypertension,preeclampsia,placental abruption,intrauterine fetal delivery length limitation,incidence of postpartum hemorrhage,neonatal weight) were compared between these two groups. Results The average gestational weeks of delivery in control group( 36. 1 ± 2. 1 weeks) were significantly earlier than those of study group( 37. 5 ± 2. 4 weeks). The incidence of pregnant hypertension,preeclampsia,placental abruption and intrauterine growth retardation( IUGR) of study group [50. 00%( 15/30),13. 33%( 4/30),0,3. 33%( 1/30) ] were significantly lower than those of control group [86. 67%( 26/30). 60. 00%( 18/30),16. 67%( 5/30),33. 33%( 10/30) ],and the difference was statistically significant( P < 0. 05). The rates of postpartum hemorrhage and cesarean section in these two groups were 6. 67%( 2/30),60. 00%( 18/30) vs. 26. 67%( 10/30) and 80. 00%( 24/30) respectively,but there was no significant difference( P> 0. 05). The birth weight( 2 912 ± 332) g in study group was significantly higher than that of control group( 2 643 ± 354) g( P < 0. 05).Stillbirth,maternal mortality and other adverse outcomes had not been occurred in patients of these 2 groups. In addition,patients in both groups had completed the medication( or placebo) without significant adverse drug reaction occurred during the medication period. Conclusion Early intervention with low-dosage aspirin in high-risk pregnant women can prevent preeclampsia and avoid the adverse outcome of pregnancy.更多还原