不同剂量阿司匹林对早发型子痫前期患者母婴结局及凝血功能的影响

目的 比较不同剂量阿司匹林对早发型子痫前期患者临床疗效、母婴结局及凝血功能的影响。方法 选取2019年3月—2020年11月在徐州市第一人民医院进行治疗的123例早发型子痫前期患者，根据用药剂量将患者分为低剂量组、中剂量组和高剂量组。3组患者分别服用阿司匹林肠溶片，于睡前口服，1次/d；用量：高剂量组，150 mg/次；中剂量组，100 mg/d；低剂量组，50 mg/d，至妊娠37周停止用药。观察并比较3组患者临床疗效、母婴结局及凝血功能。结果 治疗后，3组患者收缩压、舒张压及蛋白尿定量均显著降低（P<0.05）；且高剂量组及中剂量组收缩压、舒张压及蛋白尿定量指标显著低于低剂量组（P<0.05）。治疗后，中剂量组患者剖宫产及早产几率分别为4.88%及7.32%，均显著低于高剂量组及低剂量组（P<0.05），中、低剂量组产后出血几率均为2.44%，显著低于高剂量组（P<0.05），3组低体质量新生儿及围产儿死亡率均无显著差异。治疗后，3组凝血酶原时间、凝血酶时间均显著延长，纤维蛋白原和D-二聚体水平显著降低（P<0.05）；治疗后，高剂量组凝血酶原时间、凝血酶时间均显著高于低、中剂量组，高剂量组纤维蛋白原水平显著低于低、中剂量组，低剂量组D-二聚体水平显著低于中、高剂量组（P<0.05）。结论 对早发型子痫前期患者中剂量（100 mg/d）阿司匹林治疗能够有效改善患者症状及母婴结局，同时对患者凝血功能影响较低，具有良好的有效性及安全性，值得推广。

Effects of different doses of aspirin on maternal and infant outcomes and coagulation function in patients with early onset preeclampsia

Objective To compare the effects of different doses of aspirin on clinical efficacy, maternal and infant outcomes and blood coagulation function of patients with early onset preeclampsia. Methods A total of 123 patients with early-onset preeclampsia who were treated in Xuzhou No.1 Peoples Hospital from March 2019 to November 2020 were selected and divided into high-dose group, medium-dose group and high-dose group according to medication dosage. 3 groups were given Aspirin Enteric-coated Tablets, once daily before going to bed. Dosage: high dose group, 150 mg/time; medium dose group, 100 mg/d, low dose group, 50 mg/d was discontinued at 37 weeks gestation. Clinical efficacy, maternal and infant outcomes and coagulation function of the 3 groups were observed and compared. Results After treatment, systolic blood pressure, diastolic blood pressure, and proteinuria in 3 groups were significantly decreased (P < 0.05). The quantitative indexes of systolic blood pressure, diastolic blood pressure, and proteinuria in high-dose and medium-dose groups were significantly lower than those in low-dose group (P < 0.05). After treatment, the rates of cesarean section and premature delivery in the medium-dose group were 4.88% and 7.32%, respectively, which were significantly lower than those in the high-dose group and the low-dose group (P < 0.05). The rates of postpartum hemorrhage in the medium-dose group and the low-dose group were 2.44%, which were significantly lower than those in the high-dose group (P < 0.05). There were no significant differences in the mortality rates of low-weight neonates and perinatal infants among the three groups. After treatment, prothrombin time and thrombin time in 3 groups were significantly prolonged, while fibrinogen and D-dimer levels were significantly decreased (P < 0.05). After treatment, prothrombin time and thrombin time in high-dose group were significantly higher than those in low-dose and medium-dose groups, the fibrinogen level in high-dose group was significantly lower than that in lowdose and medium-dose groups, and the D-dimer level in low-dose group was significantly lower than that in medium-dose and highdose groups (P < 0.05). Conclusion For patients with early onset preeclampsia, medium dose (100 mg/d) aspirin can effectively improve the symptoms and maternal and infant outcomes, and has a low effect on the coagulation function of patients. It has good efficacy and safety, and is worthy of promotion.