目的 比較不同劑量阿司匹林對(duì)早發(fā)型子癇前期患者臨床療效、母嬰結(jié)局及凝血功能的影響。方法 選取2019年3月—2020年11月在徐州市第一人民醫(yī)院進(jìn)行治療的123例早發(fā)型子癇前期患者，根據(jù)用藥劑量將患者分為低劑量組、中劑量組和高劑量組。3組患者分別服用阿司匹林腸溶片，于睡前口服，1次/d；用量：高劑量組，150 mg/次；中劑量組，100 mg/d；低劑量組，50 mg/d，至妊娠37周停止用藥。觀察并比較3組患者臨床療效、母嬰結(jié)局及凝血功能。結(jié)果 治療后，3組患者收縮壓、舒張壓及蛋白尿定量均顯著降低（P<0.05）；且高劑量組及中劑量組收縮壓、舒張壓及蛋白尿定量指標(biāo)顯著低于低劑量組（P<0.05）。治療后，中劑量組患者剖宮產(chǎn)及早產(chǎn)幾率分別為4.88%及7.32%，均顯著低于高劑量組及低劑量組（P<0.05），中、低劑量組產(chǎn)后出血幾率均為2.44%，顯著低于高劑量組（P<0.05），3組低體質(zhì)量新生兒及圍產(chǎn)兒死亡率均無(wú)顯著差異。治療后，3組凝血酶原時(shí)間、凝血酶時(shí)間均顯著延長(zhǎng)，纖維蛋白原和D-二聚體水平顯著降低（P<0.05）；治療后，高劑量組凝血酶原時(shí)間、凝血酶時(shí)間均顯著高于低、中劑量組，高劑量組纖維蛋白原水平顯著低于低、中劑量組，低劑量組D-二聚體水平顯著低于中、高劑量組（P<0.05）。結(jié)論 對(duì)早發(fā)型子癇前期患者中劑量（100 mg/d）阿司匹林治療能夠有效改善患者癥狀及母嬰結(jié)局，同時(shí)對(duì)患者凝血功能影響較低，具有良好的有效性及安全性，值得推廣。

Objective To compare the effects of different doses of aspirin on clinical efficacy, maternal and infant outcomes and blood coagulation function of patients with early onset preeclampsia. Methods A total of 123 patients with early-onset preeclampsia who were treated in Xuzhou No.1 Peoples Hospital from March 2019 to November 2020 were selected and divided into high-dose group, medium-dose group and high-dose group according to medication dosage. 3 groups were given Aspirin Enteric-coated Tablets, once daily before going to bed. Dosage: high dose group, 150 mg/time; medium dose group, 100 mg/d, low dose group, 50 mg/d was discontinued at 37 weeks gestation. Clinical efficacy, maternal and infant outcomes and coagulation function of the 3 groups were observed and compared. Results After treatment, systolic blood pressure, diastolic blood pressure, and proteinuria in 3 groups were significantly decreased (P < 0.05). The quantitative indexes of systolic blood pressure, diastolic blood pressure, and proteinuria in high-dose and medium-dose groups were significantly lower than those in low-dose group (P < 0.05). After treatment, the rates of cesarean section and premature delivery in the medium-dose group were 4.88% and 7.32%, respectively, which were significantly lower than those in the high-dose group and the low-dose group (P < 0.05). The rates of postpartum hemorrhage in the medium-dose group and the low-dose group were 2.44%, which were significantly lower than those in the high-dose group (P < 0.05). There were no significant differences in the mortality rates of low-weight neonates and perinatal infants among the three groups. After treatment, prothrombin time and thrombin time in 3 groups were significantly prolonged, while fibrinogen and D-dimer levels were significantly decreased (P < 0.05). After treatment, prothrombin time and thrombin time in high-dose group were significantly higher than those in low-dose and medium-dose groups, the fibrinogen level in high-dose group was significantly lower than that in lowdose and medium-dose groups, and the D-dimer level in low-dose group was significantly lower than that in medium-dose and highdose groups (P < 0.05). Conclusion For patients with early onset preeclampsia, medium dose (100 mg/d) aspirin can effectively improve the symptoms and maternal and infant outcomes, and has a low effect on the coagulation function of patients. It has good efficacy and safety, and is worthy of promotion.

R984

江蘇省婦幼健康重點(diǎn)學(xué)科建設(shè)項(xiàng)目資助課題（蘇衛(wèi)辦婦幼【2017】16號(hào)）