摘要
目的探究小剂量阿司匹林联合拉贝洛尔治疗妊娠高血压(hypertensive disorders in pregnancy,HDP)的临床效果。方法选择76例HDP孕妇,经1∶1倾向性匹配评分法成功匹配30对患者,分为对照组(30例,拉贝洛尔治疗)和观察组(30例,小剂量阿司匹林和拉贝洛尔联用),分析2组孕妇血压和尿蛋白状况、血清和胎盘生长因子(placental growth factor,PLGF)与妊娠相关蛋白A妊娠相关蛋白A(pregnancy associated plasma protein A,PAPP-A)水平、凝血功能、炎症趋化因子[趋化因子配体16(CXC chemokine ligand 16,CXCL16)、不规则趋化因子(fractalkine,FKN)、单核/巨噬细胞趋化蛋白1(monocyte chemoattractant protein 1,MCP-1)]、分娩方式、妊娠结局及产科并发症情况。结果用药后7 d,2组孕妇收缩压、舒张压及24 h尿蛋白水平均较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05);分娩前,2组孕妇血清和胎盘中的PAPP-A水平较用药前降低,血清和胎盘中的PLGF水平较用药前升高,且观察组孕妇血清和胎盘中的PAPP-A水平低于对照组,血清和胎盘中的PLGF水平高于对照组,差异有统计学意义(P<0.05);分娩前,2组孕妇凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)较用药前延长,FIB水平较用药前降低,且观察组孕妇PT、APTT长于对照组,纤维蛋白原(fibrinogen,FIB)水平低于对照组,差异有统计学意义(P<0.05);分娩前,2组孕妇CXCL16、FNK、MCP-1水平较用药前降低,且观察组孕妇CXCL16、FNK、MCP-1水平低于对照组,差异有统计学意义(P<0.05);追踪至孕妇分娩,观察组孕妇剖宫产率(20.00%)和早产率(6.67%)低于对照组(46.67%、26.67%)(均P<0.05),观察组与对照组孕妇产科并发症发生率(10.00%vs 23.33%)比较,差异无统计学意义(P>0.05);用药期间,2组孕妇均无严重不良反应。结论HDP孕妇应用小剂量阿司匹林可有效降低血压水平,降低PAPP-A水平并提高PLG
Objective To explore the clinical effect of ow-dose aspirin combined with labetalol in the treatment of hypertension disorders in pregnancy(HDP).Methods Seventy-six pregnant women with HDP were selected,and 30 pairs of patients were successfully matched according to the 1∶1 propensity matching scoring method,and divided into a control group(30 patients,labetalol treatment)and an observation group(30 patients,low-dose aspirin and labetalol combination).Blood pressure,urine protein status,serum and placental growth factor(PLGF)and pregnancy associated protein A(PAPP-A)levels,coagulation,inflammatory chemokines[chemokine ligand 16(CXCL16),fractalkine(FKN),monocyte chemoattractant protein 1(MCP-1)],mode of delivery,pregnancy outcome and obstetric complications of both two groups were analyzed and compared.Results At 7 d after the administration of the drug,the systolic blood pressure,diastolic blood pressure and 24-hour urinary protein levels of pregnant women in the two groups were lower than those before treatment,and the observation group showed lower indicators compared with the control group with a statistically significant difference(P<0.05).Before delivery,the levels of PAPP-A in serum and placenta of pregnant women in the two groups were lower and the levels of PLGF in serum and placenta were higher than those before drug administration,and the levels of PAPP-A in the observation group were lower than those in the control group and the levels of PLGF were higher than those in the control group,and the difference was statistically significant(P<0.05).Before delivery,the prothrombin time(PT)and activated partial thromboplastin time(APTT)in the two groups were longer and the FIB level was lower than those before drug administration,and the PT and APTT in the observation group were longer than those in the control group,and the fibrinogen(FIB)level was lower than that in the control group,and the difference was statistically significant(P<0.05).Before delivery,the levels of CXCL16,FNK,and MCP-1 of pregnant wome
作者
王雪勤
郝玉娟
丁青
WANG Xueqin;HAO Yujuan;DING Qing(Department of Obstetrics and Gynecology,Xuchang Central Hospital,Xuchang Henan 461000,China)
出处
《河南医学高等专科学校学报》
2024年第2期153-158,共6页
Journal of Henan Medical College
关键词
妊娠高血压
小剂量阿司匹林
拉贝洛尔
胎盘生长因子
凝血功能
hypertensive disorders in pregnancy
low-dose aspirin
labetalol
placental growth factor
coagulation function
