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肝素治疗妊娠重度子痫前期和肾小球肾炎。

Heparin treatment in severe preeclampsia and glomerulonephritis in pregnancy.

作者信息

Fairley K F, Adey F D, Ross I C, Kincaid-Smith P

出版信息

Perspect Nephrol Hypertens. 1976;5:103-12.

PMID:1005029
Abstract

Thirty patients have been treated with heparin during pregnancy or in the immediate postpartum period. Twenty had severe preclamptic toxemia. Five presented before 30 weeks and in addition had low estriol levels and high blood ureas. The chance of a successful pregnancy in such patients is very low indeed; however 3 of these 5 patients had living babies. Even in patients presenting after 30 weeks of gestation, if severe preeclampsia is accompanied by low estriol levels and high blood urea levels, the anticipated fetal survival is poor. However, all 5 patients in this group were treated with heparin and had living babies. In the small group of patients with glomerulonephritis, there was a suggestion that heparin treatment may have been of value. Biopsy studies suggested that heparin may help to prevent lesions in arteries and arterioles which have been noted to develop in association with preeclamptic toxemia. In four patients treated in the postpartum period, there was possible benefit in terms of renal function, intravascular coagulation, vessel lesions, and subsequent successful pregnancies.

摘要

30名患者在孕期或产后立即接受了肝素治疗。其中20名患有重度子痫前期。5名在孕30周前就诊,此外雌三醇水平低且血尿素高。这类患者成功妊娠的几率确实非常低;然而,这5名患者中有3名产下了存活婴儿。即使是在妊娠30周后就诊的患者中,如果重度子痫前期伴有雌三醇水平低和血尿素水平高,预期胎儿存活率也很低。然而,该组中的所有5名患者均接受了肝素治疗并产下了存活婴儿。在一小群肾小球肾炎患者中,有迹象表明肝素治疗可能有价值。活检研究表明,肝素可能有助于预防与子痫前期相关的动脉和小动脉病变。在产后接受治疗的4名患者中,在肾功能、血管内凝血、血管病变及随后的成功妊娠方面可能有益。

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