CAJ | 학술논문

目的：评价低剂量阿司匹林（ LDA）在预防高危孕妇子痫前期（ PE）的作用及疗效。方法采用随机、对照、双盲实验将480名12周及20周孕妇分为12个组别，分别给予50mg／d、100mg／d及150mg／d剂量的LAD和安慰剂，比较各组间的子痫发生情况、分娩孕周、孕妇产后出血量、早产及胎儿生长受限、新生儿出血性疾病发生、新生儿死亡率等情况。观察合适的服用LDA的时间和剂量。结果12周与20周孕妇不同剂量LDA组结果均显示，服用LDA的子痫发生率均低于服用安慰剂组，而且以100mg／d组别子痫发生率最低，差异具有统计学意义（χ2＝29．838，P＜0．05）；12周结果显示早产发生、新生儿出血性疾病发生情况方面，服用LDA与服用安慰剂均无统计学差异（χ2值分别为1．441、1．034，均P＞0．05）；但是服用LDA组发生胎儿生长受限及新生儿死亡情况显著低于服用安慰剂组，且差异有统计学意义（χ2值分别为13．317、15．984，均P＜0．05）。20周结果显示在早产发生、胎儿生长受限、新生儿出血性疾病发生情况方面，服用LDA与服用安慰剂并无统计学差异（χ2值分别为1．441、6．117、0．835，均P＞0．05）；但是服用LDA组发生新生儿死亡情况显著低于服用安慰剂组，且差异有统计学意义（χ2＝15．984，P＜0．05）；12孕周服用LDA各组较20孕周服用LDA各组的子痫发生率低显著降低（χ2＝11．663，P＜0．05）。结论12周服用LDA100mg／d可以有效降低PE的发生，具有预防效果。
목적：평개저제량아사필림（ LDA）재예방고위잉부자간전기（ PE）적작용급료효。방법채용수궤、대조、쌍맹실험장480명12주급20주잉부분위12개조별，분별급여50mg／d、100mg／d급150mg／d제량적LAD화안위제，비교각조간적자간발생정황、분면잉주、잉부산후출혈량、조산급태인생장수한、신생인출혈성질병발생、신생인사망솔등정황。관찰합괄적복용LDA적시간화제량。결과12주여20주잉부불동제량LDA조결과균현시，복용LDA적자간발생솔균저우복용안위제조，이차이100mg／d조별자간발생솔최저，차이구유통계학의의（χ2＝29．838，P＜0．05）；12주결과현시조산발생、신생인출혈성질병발생정황방면，복용LDA여복용안위제균무통계학차이（χ2치분별위1．441、1．034，균P＞0．05）；단시복용LDA조발생태인생장수한급신생인사망정황현저저우복용안위제조，차차이유통계학의의（χ2치분별위13．317、15．984，균P＜0．05）。20주결과현시재조산발생、태인생장수한、신생인출혈성질병발생정황방면，복용LDA여복용안위제병무통계학차이（χ2치분별위1．441、6．117、0．835，균P＞0．05）；단시복용LDA조발생신생인사망정황현저저우복용안위제조，차차이유통계학의의（χ2＝15．984，P＜0．05）；12잉주복용LDA각조교20잉주복용LDA각조적자간발생솔저현저강저（χ2＝11．663，P＜0．05）。결론12주복용LDA100mg／d가이유효강저PE적발생，구유예방효과。
Objective To evaluate the effectiveness of low-dose aspirin (LDA) on preventing preeclampsia (PE) in high-risk pregnant women.Methods A total of 480 women at 12 and 20 weeks of gestation were divided into 12 groups in a randomized, controlled and double-blind study, and they were given 50mg/d, 100mg/d, 150mg/d dose of aspirin and placebo.The incidence of eclampsia, gestational weeks, amount of postpartum hemorrhage, premature birth and fetal growth restriction, neonatal hemorrhagic disease and neonatal mortality rate were compared among each groups.The right time and dose of taking LDA were observed.Results The incidence of eclampsia in groups taking LDA was significantly lower than that of the groups taking placebo,and it was lowest in the group taking 100mg/d of aspirin (χ2 =29.838, P<0.05).In pregnant women at 12 gestational week, there was no significant difference in the occurrence of premature delivery and neonatal hemorrhagic disease between groups taking LDA and those taking placebo (χ2 value was 1.441 and 1.034, respectively, both P>0.05) , but the occurrence of fetal growth restriction and neonatal death in groups taking LDA was significantly lower than that of the groups taking placebo (χ2 value was 13.317 and 15.984, respectively, both P <0.05).In pregnant women at 20 gestational week, the groups taking LDA were not significantly different from those taking placebo in the occurrence of premature delivery, fetal growth restriction and neonatal hemorrhagic disease (χ2 value was 1.441, 6.117 and 0.835, respectively, all P>0.05), but the incidence of neonatal death in groups taking LDA was significantly lower than that of the groups taking placebo (χ2 =15.984,P<0.05). The incidence of eclampsia in women taking LDA at 12 weeks of gestation was significantly lower than that of the women taking LDA at 20 weeks of gestation (χ2 =11.663, P<0.05).Conclusion Women at 12 weeks of gestation taking 100mg/d of LDA can effectively reduce the incidence of PE.