低分子量肝素治疗对患有血栓形成倾向的女性先兆子痫复发率有影响吗？
Recurrence rate of pre-eclampsia in women with thrombophilia influenced by low-molecular-weight heparin treatment?
作者信息
Kalk J J, Huisjes A J M, de Groot C J M, van Beek E, van Pampus M G, Spaanderman M E A, van Eyck J, Oei S G, Bezemer P D, de Vries J I P
机构信息
Department of Obstetrics and Gynaecology, VU University Medical Centre, PO Box 7057, 1007 MB Amsterdam.
出版信息
Neth J Med. 2004 Mar;62(3):83-7.
OBJECTIVES
(1) To assess the recurrence rate of pre-eclampsia in women with this history before 34 weeks of pregnancy and thrombophilia. (2) To evaluate the effects of low-molecular-weight heparin (LMWH) on pregnancy outcome.
METHODS
In a multicentre retrospective study subsequent pregnancies of women with a history of pre-eclampsia necessitating birth before 34 weeks and thrombophilia were analysed. Of 58 women, 26 received LMWH and aspirin (ASA) and 32 ASA (22) or no (10) medication in their subsequent pregnancies.
RESULTS
In eight women treated with LMWH and ASA and in 16 women receiving ASA or no medication pre-eclampsia recurred in the subsequent pregnancy. (OR 0.55, 95% CI 0.15-1.31) There were no significant differences in birth weight or gestational age between both groups.
CONCLUSIONS
The recurrence rate of pre-eclampsia in women with thrombophilic disorders is high in this small retrospective study. No positive effect was found for LMWH treatment. A multicentred randomised study has been started to reach an adequate number of patients to evaluate the influence of LMWH treatment.
目的
（1）评估有子痫前期病史且患有易栓症的女性在妊娠34周前子痫前期的复发率。（2）评估低分子量肝素（LMWH）对妊娠结局的影响。
方法
在一项多中心回顾性研究中，分析了有子痫前期病史且在34周前分娩且患有易栓症的女性的后续妊娠情况。58名女性中，26名在后续妊娠中接受了LMWH和阿司匹林（ASA）治疗，32名接受了ASA治疗（22名）或未接受任何药物治疗（10名）。
结果
在接受LMWH和ASA治疗的8名女性以及接受ASA治疗或未接受任何药物治疗的16名女性中，后续妊娠中出现了子痫前期复发。（比值比0.55，95%置信区间0.15 - 1.31）两组之间出生体重或孕周无显著差异。
结论
在这项小型回顾性研究中，患有易栓症的女性子痫前期复发率较高。未发现LMWH治疗有积极效果。已启动一项多中心随机研究，以纳入足够数量的患者来评估LMWH治疗的影响。
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