目的：观察低分子肝素钙联合丹参治疗早发型重度子痫前期的临床疗效。方法选取2006年1月至2012年6月于河北省儿童医院妇产科住院分娩的116例早发型重度子痫前期孕妇为研究对象,年龄为20~35岁,孕龄为26~34孕周。按照自愿原则,将其分为 A 组(n=26,采用硫酸镁+低分子肝素钙+丹参治疗),B组(n=28,采用硫酸镁+低分子肝素钙治疗),C 组(n=30,采用硫酸镁+丹参治疗), D组(n=32,以硫酸镁为主的综合治疗)。4组孕妇的年龄、孕龄、体质量指数、孕次、产次、视网膜病变程度等比较,差异均无统计学意义(P>0.05)(本研究遵循的程序符合河北省儿童医院人体试验委员会制定的伦理学标准,得到该委员会批准,分组征得受试对象的知情同意,并与之签署临床研究知情同意书)。对4组患者治疗后自觉症状改善率、水肿消退率、平均动脉压(MAP)、24 h 尿蛋白定量、产后出血量、凝血指标[凝血酶原时间(PT)、部分凝血活酶时间(APTT)]、纤溶指标及血脂水平[甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白(apo)A、apoB]、视网膜病变发生率及并发症进行统计学分析。结果 A组患者自觉症状改善率显著高于 D 组,且差异有统计学意义(χ2=4.4387；P<0.05),与B,C组比较,差异均无统计学意义(χ2=0.3885,0.3849；P=0.50)。A 组患者的水肿消退率显著高于B,D组,且差异均有统计学意义(χ2=2.2300,4.3467；P<0.05),与 C 组比较,差异无统计学意义(χ2=0.5958,P>0.05)。本研究结果亦显示,A组患者的 MAP及24 h尿蛋白定量显著较D组下降,且差异均有统计学意义(t=5.077,4.962；P<0.05),但 A 组患者的产后出血量和 B组、C组、D组比较,差异均无统计学意义(t=0.2597,1.0769,1.5185；P>0.05)。A 组患者的 PT、APTT、Fg、DD水平与B组、C 组、D 组比较,差异均有统计学意义(PT：t=5.2556,3.3639,4.8820；P<0.05。APTT：t=2.3112,2.8467,3.6866；P<0.05。Fg：t=5.6714,3.7992,20.8247；P<0.05。DD：t=4.2668,9.7201,7.0460；P<0.05)。此外,A 组患者 TG、TC、apo-B水平下降,而 HDL 及 apo-A 水平增加,与D组比较,差异均有统计学意义(t=3.0814,2.8891,2.5326,1.7170,4.2828,t=2.2076；P<0.05)。治疗后 A组、B组患者的视网膜病变发生率与治疗前比较,差异均有统计学意义(χ2=3.1720,2.8769；P<0.05)。C组和D组与治疗前比较,差异均无统计学意义(χ2=1.1249,1.4603；P>0.05)。治疗后 A组分别与B,C,D组比较,差异均无统计学意义(χ2=0.3416,1.9408,1.8047；P>0.05)。同时, A组患者的并发症发生率显著低于D组,且差异有统计学意义(χ2=3.1344,P<0.05),但与 B组和 C 组比较,差异均无统计学意义(χ2=0.0000,2.1819；P>0.05)。结论低分子肝素钙联合丹参治疗早发型重度子痫前期较单一用药具有更好的临床疗效。
目的：觀察低分子肝素鈣聯閤丹參治療早髮型重度子癇前期的臨床療效。方法選取2006年1月至2012年6月于河北省兒童醫院婦產科住院分娩的116例早髮型重度子癇前期孕婦為研究對象,年齡為20~35歲,孕齡為26~34孕週。按照自願原則,將其分為 A 組(n=26,採用硫痠鎂+低分子肝素鈣+丹參治療),B組(n=28,採用硫痠鎂+低分子肝素鈣治療),C 組(n=30,採用硫痠鎂+丹參治療), D組(n=32,以硫痠鎂為主的綜閤治療)。4組孕婦的年齡、孕齡、體質量指數、孕次、產次、視網膜病變程度等比較,差異均無統計學意義(P>0.05)(本研究遵循的程序符閤河北省兒童醫院人體試驗委員會製定的倫理學標準,得到該委員會批準,分組徵得受試對象的知情同意,併與之籤署臨床研究知情同意書)。對4組患者治療後自覺癥狀改善率、水腫消退率、平均動脈壓(MAP)、24 h 尿蛋白定量、產後齣血量、凝血指標[凝血酶原時間(PT)、部分凝血活酶時間(APTT)]、纖溶指標及血脂水平[甘油三酯(TG)、總膽固醇(TC)、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)、載脂蛋白(apo)A、apoB]、視網膜病變髮生率及併髮癥進行統計學分析。結果 A組患者自覺癥狀改善率顯著高于 D 組,且差異有統計學意義(χ2=4.4387；P<0.05),與B,C組比較,差異均無統計學意義(χ2=0.3885,0.3849；P=0.50)。A 組患者的水腫消退率顯著高于B,D組,且差異均有統計學意義(χ2=2.2300,4.3467；P<0.05),與 C 組比較,差異無統計學意義(χ2=0.5958,P>0.05)。本研究結果亦顯示,A組患者的 MAP及24 h尿蛋白定量顯著較D組下降,且差異均有統計學意義(t=5.077,4.962；P<0.05),但 A 組患者的產後齣血量和 B組、C組、D組比較,差異均無統計學意義(t=0.2597,1.0769,1.5185；P>0.05)。A 組患者的 PT、APTT、Fg、DD水平與B組、C 組、D 組比較,差異均有統計學意義(PT：t=5.2556,3.3639,4.8820；P<0.05。APTT：t=2.3112,2.8467,3.6866；P<0.05。Fg：t=5.6714,3.7992,20.8247；P<0.05。DD：t=4.2668,9.7201,7.0460；P<0.05)。此外,A 組患者 TG、TC、apo-B水平下降,而 HDL 及 apo-A 水平增加,與D組比較,差異均有統計學意義(t=3.0814,2.8891,2.5326,1.7170,4.2828,t=2.2076；P<0.05)。治療後 A組、B組患者的視網膜病變髮生率與治療前比較,差異均有統計學意義(χ2=3.1720,2.8769；P<0.05)。C組和D組與治療前比較,差異均無統計學意義(χ2=1.1249,1.4603；P>0.05)。治療後 A組分彆與B,C,D組比較,差異均無統計學意義(χ2=0.3416,1.9408,1.8047；P>0.05)。同時, A組患者的併髮癥髮生率顯著低于D組,且差異有統計學意義(χ2=3.1344,P<0.05),但與 B組和 C 組比較,差異均無統計學意義(χ2=0.0000,2.1819；P>0.05)。結論低分子肝素鈣聯閤丹參治療早髮型重度子癇前期較單一用藥具有更好的臨床療效。
목적：관찰저분자간소개연합단삼치료조발형중도자간전기적림상료효。방법선취2006년1월지2012년6월우하북성인동의원부산과주원분면적116례조발형중도자간전기잉부위연구대상,년령위20~35세,잉령위26~34잉주。안조자원원칙,장기분위 A 조(n=26,채용류산미+저분자간소개+단삼치료),B조(n=28,채용류산미+저분자간소개치료),C 조(n=30,채용류산미+단삼치료), D조(n=32,이류산미위주적종합치료)。4조잉부적년령、잉령、체질량지수、잉차、산차、시망막병변정도등비교,차이균무통계학의의(P>0.05)(본연구준순적정서부합하북성인동의원인체시험위원회제정적윤리학표준,득도해위원회비준,분조정득수시대상적지정동의,병여지첨서림상연구지정동의서)。대4조환자치료후자각증상개선솔、수종소퇴솔、평균동맥압(MAP)、24 h 뇨단백정량、산후출혈량、응혈지표[응혈매원시간(PT)、부분응혈활매시간(APTT)]、섬용지표급혈지수평[감유삼지(TG)、총담고순(TC)、고밀도지단백담고순(HDL-C)、저밀도지단백담고순(LDL-C)、재지단백(apo)A、apoB]、시망막병변발생솔급병발증진행통계학분석。결과 A조환자자각증상개선솔현저고우 D 조,차차이유통계학의의(χ2=4.4387；P<0.05),여B,C조비교,차이균무통계학의의(χ2=0.3885,0.3849；P=0.50)。A 조환자적수종소퇴솔현저고우B,D조,차차이균유통계학의의(χ2=2.2300,4.3467；P<0.05),여 C 조비교,차이무통계학의의(χ2=0.5958,P>0.05)。본연구결과역현시,A조환자적 MAP급24 h뇨단백정량현저교D조하강,차차이균유통계학의의(t=5.077,4.962；P<0.05),단 A 조환자적산후출혈량화 B조、C조、D조비교,차이균무통계학의의(t=0.2597,1.0769,1.5185；P>0.05)。A 조환자적 PT、APTT、Fg、DD수평여B조、C 조、D 조비교,차이균유통계학의의(PT：t=5.2556,3.3639,4.8820；P<0.05。APTT：t=2.3112,2.8467,3.6866；P<0.05。Fg：t=5.6714,3.7992,20.8247；P<0.05。DD：t=4.2668,9.7201,7.0460；P<0.05)。차외,A 조환자 TG、TC、apo-B수평하강,이 HDL 급 apo-A 수평증가,여D조비교,차이균유통계학의의(t=3.0814,2.8891,2.5326,1.7170,4.2828,t=2.2076；P<0.05)。치료후 A조、B조환자적시망막병변발생솔여치료전비교,차이균유통계학의의(χ2=3.1720,2.8769；P<0.05)。C조화D조여치료전비교,차이균무통계학의의(χ2=1.1249,1.4603；P>0.05)。치료후 A조분별여B,C,D조비교,차이균무통계학의의(χ2=0.3416,1.9408,1.8047；P>0.05)。동시, A조환자적병발증발생솔현저저우D조,차차이유통계학의의(χ2=3.1344,P<0.05),단여 B조화 C 조비교,차이균무통계학의의(χ2=0.0000,2.1819；P>0.05)。결론저분자간소개연합단삼치료조발형중도자간전기교단일용약구유경호적림상료효。
Objective To investigate the clinical effects of low molecular heparin calcium combined with salvia miltiorrhiza on early onset severe pre-eclampsia.Methods A total of 116 patients (aged 20-35 years)with early onset severe pre-eclampsia at 26-34 weeks of gestational age were divided into four group by their own will, group A (n=26, magnesium sulfate+low molecular heparin calcium+salvia miltiorrhiza),group B (n=28,magnesium sulfate+low molecular heparin calcium),group C (n=30, magnesium sulfate+salvia miltiorrhiza),group D (n=32,magnesium sulfate conventional treatment only). There were no significant differences among four groups about age,gestational age,body weight index, gravidity,parity as well as degrees of retinopathy.The study protocol was approved by the Ethical Review Board of Investigation in Children Hospital of Hebei Province.Informed consent was obtained from all participates.Improvement of symptoms,edema disappeared,mean arterial pressure (MAP),24 hours urinary protein excretion,postpartum bleeding,prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen (Fg),D-dimer (DD),triglyceride(TG),total cholesterol (TC),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),apolipoprotein (apo)A, apoB,incidence rate of retinopathy,and complications were analyzed statistically among four groups. Results The symptoms improved rate of group A was higher than that of group D [92.31% (24/26)vs. 65.63%(21/32)],with significant difference (χ2 =4.438 7,P<0.05),but there were no significant differences between group A and group B,group A and group C (χ2 =0.388 5,0.384 9;P=0.50). Compared with group A,the edema disappeared rate of group B and group D were lower with statistically significant difference (χ2=2.230 0,4.346 7;P<0.05).The level of MAP and urine protein of group A were lower than those of group B,with significant difference (t=5.077,4.962;P<0.05),but there were no significant differences on postpartum bleeding among four groups (t=0.259 7,1.076 9,1.518 5,P>0.05).Compared with group A,the level of PT,APTT,Fg and DD of group B,group C and group D had significant differences (PT:t= 5.255 6,3.363 9,4.882 0;P<0.05.APTT:t= 2.311 2,2.846 7,3.686 6;P<0.05.Fg:t= 5.671 4,3.799 2,20.824 7;P<0.05.DD:t=4.266 8,9.720 1,7.046 0;P<0.05).In addition,compared with group D,the level of TG,TC,apo-B of group A were decreased and the level of HDL and apo-A were increased,with significant differences (t=3.081 4,2.889 1,2.532 6,1.717 0, 4.282 8,2.207 6;P<0.05).There had significant differences of retinopathy incidence rated before and after the treatment in both group A and group B (χ2=3.172 0,2.876 9;P<0.05),and there had no significant differences in both group C and group D (χ2=1.124 9,1.460 3;P>0.05).And compared with groups A, the retinopathy incidence rates of group B,C and D had no significant differences (χ2=0.341 6,1.940 8, 1.804 7;P>0.05).Furthermore,the complication rate of group A were significant lower than that of group D (χ2=3.1344,P<0.05),but there had no significant differences between group A and B,group A and group C (χ2=0.000 0,2.181 9;P>0.05).Conclusions The clinical effects of low molecular heparin calcium combined with salvia miltiorrhiza in the treatment of early onset severe preeclampsia are better than single medication.
