小剂量阿司匹林辅助治疗妊娠高血压的效果与安全性

应祝 徐蕾

[關键词] 阿司匹林;硝苯地平;妊娠高血压;血管内皮功能;凝血功能

[中图分类号] R714.24          [文献标识码] B          [文章编号] 1673-9701（2021）29-0005-03

Efficacy and safety of low-dose aspirin in adjuvant treatment of gestational hypertension

YING Zhu   XU Lei

Department of Obstetrics，Women′s Hospital of Nanjing Medical University，Nanjing   210000，China

[Abstract] Objective To investigate the efficacy and safety of low-dose aspirin in the adjuvant treatment of hypertension during pregnancy. Methods A total of 84 patients with gestational hypertension who were admitted to our hospital from March 2019 to November 2020 were selected as the research objects，and were divided into the control group and the research group according to the random number table method，with 42 patients in each group. Patients in the control group were treated with nifedipine （10 mg/time， twice a day， orally after meals）， and patients in the research group were treated with nifedipine combined with aspirin （50 mg/time， once a day，orally after meals）. Patients in both groups were continuously treated until 7 days before the expected date of delivery. The blood pressures，vascular endothelial functions， coagulation functions，clinical efficacy and pregnancy outcomes of the two groups were compared before and after treatment. Results After treatment，the blood pressure，ET，FIB and DD in the study group were lower than those in the control group，and the differences were statistically significant（P<0.05）; the NO in the study group was higher than that in the control group after treatment， and the difference was statistically significant（P<0.05）; the APTT and PT in the study group were longer than those in the control group， and the differences were statistically significant （P<0.05）; the clinical efficacy and pregnancy outcome in the study group were better than those in the control group， and the differences were statistically significant （P<0.05）. Conclusion The adjuvant treatment of low-dose aspirin in gestational hypertension can significantly improve the vascular endothelial function and coagulation function of patients with significant effect of lowering blood pressure and good clinical efficacy. Meanwhile， it can also improve the pregnancy outcome of patients，which is worthy of clinical promotion.

[Key words] Aspirin; Nifedipine; Gestational hypertension; Vascular endothelial function; Coagulation function

妊娠高血压属于妊娠期女性常见的并发症，往往伴随着头晕、小动脉痉挛、水肿、心悸、蛋白尿等临床症状[1];病情严重者甚至会出现胎盘早剥、宫缩乏力、新生儿窒息等不良事件，对产妇及新生儿造成严重不良影响[2]。随着“两孩政策”的推行，妇产科面临妊娠高血压的挑战越来越多。目前临床上主要采用镇静、降压、有指征扩容等方式治疗，甚至是终止妊娠，但临床效果难以令人满意。因此如何有效干预妊娠高血压，改善妊娠结局，成为相关人员研究的重点。阿司匹林具有抑制血小板环氧合酶的作用，并能够降低血栓素A2的合成，进而使血管舒张、血压降低[3]。基于以上原因，本研究旨在探讨小剂量阿司匹林辅助治疗妊娠高血压的效果和安全性，以期为临床用药提供参考，现报道如下。

1 资料与方法

1.1 一般资料

选取2019年3月至2020年11月我院收治的84例妊娠高血压患者为研究对象，按照随机数字表法分为对照组和研究组，每组各42例。对照组患者年龄21～37岁，平均（29.1±7.6）岁，孕龄23～34周，平均（28.7±5.2）周，初产妇23例，经产妇19例，平均收缩压（168.7±15.2）mmHg，平均舒张压（124.6±13.1）mmHg;研究组患者年龄22～37岁，平均（29.4±7.3）岁，孕龄22～35周，平均（28.5±6.1）周，初产妇22例，经产妇20例，平均收缩压（170.3±14.8）mmHg，平均舒张压（126.4±13.5）mmHg。两组的一般资料比较，差异无统计学意义（P>0.05），具有可比性。本研究获取医院医学伦理委员会审批。纳入标准[4]：①符合妊娠高血压的诊断标准者;②患者或其家属自愿签署知情同意书。……