阿司匹林及低分子肝素在子痫前期中应用的研究进展

子痫前期是妊娠中晚期常见的一种特发疾病，其病情变化快，发生HELLP综合征、胎盘早剥、子痫、早产、胎儿窘迫等严重并发症的概率高，是导致发展中国家孕妇不良妊娠结局的主要原因之一，目前缺乏有效的防治措施。子痫前期的基本病理改变为全身小动脉痉挛，致滋养细胞受损、侵蚀不良，胎盘浅着床，合体滋养细胞缺血、缺氧，炎性因子、促凝物质释放，使血压升高、凝血与纤溶系统失衡，血液早期处于高凝状态。低分子肝素（low molecular weight heparin，LMWH）和阿司匹林是产科常用的两种具有抗凝作用的药物，由于子痫前期患者与正常孕妇的凝血状态存在差异，这两种药物在子痫前期中的应用引起了国内外学者的关注。现就其在子痫前期防治过程中的有效性及安全性的研究进展进行综述。

Research Progress of Aspirin and Low Molecular Weight Heparin in Preeclampsia

Pre-eclampsia (PE) is a common idiopathic disease occurring in pregnant women after 20 weeks of gestation. It changes rapidly, and the probability of serious complications of HELLP syndrome, placental abruption, preeclampsia, preterm birth, and fetal distress is high. PE is one of the leading causes of poor pregnancy outcomes in developing countries, and currently there is a lack of effective prevention and control measures. The basic pathological change of preeclampsia is systemic arteriospasm resulting in the poor erosion of gestational trophoblast, and shallow placental implantation, syncytio cells are ischemic and anoxic, inflammatory factor and procoagulant release, the blood pressure is raised, and the blood coagulation and fibrinolysis system are unbalanced, the blood is hypercoagulable in the early stage of the disease. Low molecular weight heparin (LMWH) and aspirin are two kinds of anticoagulant drugs commonly used in obstetrics. The coagulation state of preeclampsia is different from that of normal pregnant women, so the application of LMWH and aspirin in PE has attracted the attention of scholars all over the world. In this paper, the research progress on the effectiveness and safety of the two drugs in the prevention and treatment of PE will be reviewed.