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目的:了解丹参、低分子肝素等抗凝药物对早发型重度子痫前期的治疗作用。方法:2006年1月～2010年3月将我院产科病房子痫前期患者65例前瞻性随机分为丹参组23例,低分子肝素组11例,丹参+低分子肝素组15例,对照组16例,收集各组患者的一般情况、分娩情况,对比分析治疗前后的尿蛋白、血常规、出凝血系列、肝肾功能、血脂等指标,了解治疗效果。结果:(1)丹参+低分子肝素组的治疗时间为11.13天,丹参组为9.05天,显著长于(SNK值不同)其他组;(2)新生儿分娩孕周平均为32.45±2.74周,新生儿体重为1533.19±489.71g,围产儿死亡率215.4‰。孕产妇死亡率0%;剖宫产率84.61%,顺产率1.54%,引产率13.85%。各组间分娩孕周、新生儿体重、围产儿和孕产妇死亡率均无显著差异(SNK均为A)。分娩的手术指征以胎儿窘迫、疾病加重为主要因素;(3)各组间治疗前后血常规、肝肾功能、凝血指标中的PT、FIB对比差值无显著差异(SNK均为A),而低分子肝素组TT增加1.35s,APTT增加3.33s,显著长于其他组(SNK值不同)。24h尿蛋白丹参组增加0.6g,增加值少于其他组。结论:应用丹参或丹参+低分子肝素治疗子痫前期患者可延长孕周,丹参缓解尿蛋白明显,低分子肝素缓解高凝状态明显,药物的有效性尚需进一步大样本研究。
Objective: To understand the therapeutic effects of anticancer drugs such as Salvia miltiorrhiza and low molecular weight heparin on early-onset severe preeclampsia. Methods: From January 2006 to March 2010, 65 cases of preeclampsia in obstetrics and gynecology hospital of our hospital were prospectively divided into three groups randomly: Salvia miltiorrhiza group (11 cases), low molecular weight heparin group (11 cases), Salvia miltiorrhiza + low molecular weight heparin group (15 cases), control group 16 cases, the general situation of patients in each group were collected, delivery situation, comparative analysis of urine protein before and after treatment, blood coagulation series, liver and kidney function, blood lipids and other indicators to understand the therapeutic effect. Results: (1) The treatment time of Salvia miltiorrhiza + LMWH group was 11.13 days, Salvia miltiorrhiza group was 9.05 days, which was significantly longer than that of other groups (SNK value was different); (2) The gestational age of Neonatal childbirth was 32.45 ± 2.74 weeks on average, Weight of 1533.19 ± 489.71g, perinatal mortality rate of 215.4 ‰. Maternal mortality rate was 0%; cesarean section rate was 84.61%, birth rate was 1.54% and induction rate was 13.85%. There was no significant difference in gestational age, newborn weight, perinatal and maternal mortality between groups (SNK was A). The indications for labor were fetus distress and aggravating disease as the main factors. (3) There were no significant differences in blood routine, liver and kidney function and coagulation index among the groups before and after treatment (SNK was A) The low-molecular-weight heparin group TT increased 1.35s, APTT increased 3.33s, significantly longer than the other groups (SNK values are different). 24h urinary protein Salvia group increased 0.6g, added value less than other groups. Conclusion: The treatment of preeclampsia with Salvia miltiorrhiza or low molecular weight heparin can prolong the gestational age. Salvia miltiorrhiza can relieve the urinary protein obviously. The low molecular weight heparin can relieve the hypercoagulable state obviously. The effectiveness of the drug needs further large sample study.