摘要
【目的】探讨硫酸镁和低分子肝素(那屈肝素钙注射液)对早发型子痫前期凝血功能、肾功能以及妊娠结局的影响。【方法】选取2008年10月至2009年8月就诊的早发型子痫前期孕妇共31例,按照随机数表单盲分为硫酸镁组(组1,n=14)和硫酸镁联合低分子肝素组(组2,n=17),观察两组血压、凝血功能、肾功能指标及妊娠结局。【结果】活化部分凝血活酶时间(APTT)在组1患者中表现为延长(1.8±2.6)s,治疗前后P=0.035,在组2延长(4.9±4.0)s,P<0.001,APTT在组2延长的幅度明显大于组1,P=0.026。组1患者凝血酶时间(TT)缩短(1.1±1.5)s,P=0.028,组2延长(3.3±7.1)s,P=0.069,两组的变化幅度比较P=0.041。组1患者尿酸水平较治疗前增加(46±64)μmol/L,P=0.03,组2增加(17±54)μmol/L,P=0.227。组1患者血清尿素氮(BUN)水平增加(0.5±1.0)mmol/L,P=0.087,组2增加(1.3±2.0)mmol/L,P=0.013。组1血肌酐(Cr)增加(12.6±18.2)μmol/L,P=0.036,组2增加(2.3±10.9)μmol/L,P=0.405。其余监测指标以及分娩结局两组对比差异无统计学意义。【结论】低分子肝素的应用并不影响降压治疗,能够抑制血管内皮受损所引起高凝状态,对肾功能以及微循环淤积可能有改善作用,不增加母婴风险。
Objective To study the effect of magnesium sulfate combining with low molecular weight heparin（LMWH,nadroparin） on coagulant function,renal function,and pregnancy outcome on early onset pre-eclampsia.Methods Thirty-one gestation aging from 28 weeks to 33 weeks was randomized single blinded grouping as Group 1（treated with magnesium sulfate,n=14）,and Group 2（treated with nadroparin combining magnesium sulfate,n=17）.Blood pressure,coagulant index,renal function index,and pregnancy outcome were observed.Results Activated partial thromboplastin time（APTT） was lengthened in both groups,P0.05,while more in Group 2（4.9 ± 4.0） s than Group 1（1.8 ± 2.6） s,P=0.026.thrombin time（TT） was（1.1 ± 1.5） s shortened in Group 1（P=0.028） while（3.3 ± 7.1） s lengthened in Group 2（P=0.069）,their difference was significant（P=0.041）.Urine acid was increased more in Group 1 [（46 ± 64） μmol/L,P=0.03] than Group 2 [（17 ± 54） μmol/L,P=0.227）.Creatinine was increased more in Group 1 [（12.56 ± 18.2） μmol/L,P=0.036] than Group 2 [（2.3 ± 10.9） μmol/L,P=0.405）.But BUN was increased less in Group 1 [（0.5 ± 1.0） mmol/L,P=0.087） than Group 2 [（1.3 ± 2.0） mmol/L,P=0.013）.Other observed indexes and pregnancy outcome showed no statistically difference.Conclusion Low molecular weight heparin showed no adverse effect on anti-hypertension,did not add any risk to pregnancy outcome,and could inhibit the hyper-coagulant state,might improve the renal function and micro-circulation dysfunction.
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2010年第5期652-656,共5页
Journal of Sun Yat-Sen University:Medical Sciences
基金
国家科技攻关计划(2004BA720A06-01)
广东省卫生厅医学科研立项(A2010171)
关键词
早发型子痫前期
低分子肝素
肾功能
妊娠结局
early onset preeclampsia
low molecular weight heparin
renal function
pregnancy outcome
