产后阿司匹林抵抗似乎与妊娠复发性高血压疾病无关。

Post-pregnancy aspirin resistance appears not to be related with recurrent hypertensive disorders of pregnancy.

作者信息

Abheiden Carolien N H, Fuijkschot Wessel W, Arduç Arda, van Diemen Jeske J K, Harmsze Ankie M, de Boer Marjon A, Thijs Abel, de Vries Johanna I P

机构信息

Department of Obstetrics and Gynecology, Institute for Cardiovascular Research (ICaR-VU), VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.

Department of Internal Medicine, Institute for Cardiovascular Research (ICaR-VU), VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2017 Mar;210:139-143. doi: 10.1016/j.ejogrb.2016.12.023. Epub 2016 Dec 21.

DOI:10.1016/j.ejogrb.2016.12.023

PMID:28033561

Abstract

OBJECTIVE

The FRUIT-RCT concluded that low-molecular-weight heparin added to aspirin compared to treatment with aspirin alone is beneficial in the prevention of early-onset hypertensive disorders of pregnancy (HD) in women with inheritable thrombophilia and prior HD and/or a small-for-gestational age (SGA) infant leading to delivery before 34 weeks gestation. The aim of this study is to answer the question whether aspirin resistance is associated with recurrent HD.

STUDY DESIGN

Women with and without recurrent HD matched for age, study arm, and chronic hypertension were invited for this follow-up study 6-16 years after they participated in the FRUIT-RCT. Aspirin resistance was tested after 10days of aspirin intake using three complementary tests: PFA-200, VerifyNow and serum thromboxane B (TXB). An independent t-test, Mann-Whitney U test, Fisher's Exact test and Chi test were used for the statistical analyses.

RESULTS

Thirteen of 24 women with recurrent HD and 16 of 24 women without recurrent HD participated. The prevalence of laboratory aspirin resistance was 34.5% according to the PFA-200, 3.4% according to the VerifyNow and 24.1% according to TXB. The prevalence of aspirin resistance by any test was 51.7%. Aspirin resistance per individual test did not differ between women with and without recurrent HD. Aspirin resistance measured by any test occurred more frequently in women without recurrent HD (p<0.01), irrespective of low-molecular-weight heparin.

CONCLUSIONS

No relation could be demonstrated between recurrent HD and aspirin resistance per test, measured up to 16 years after pregnancy. On the contrary, complementary aspirin resistance measurements were encountered more frequently in women without recurrent HD.

摘要

目的

“FRUIT-RCT”研究得出结论，对于患有遗传性易栓症且既往有妊娠期高血压疾病（HD）和/或小于胎龄儿（SGA）并在孕34周前分娩的女性，在阿司匹林基础上加用低分子量肝素在预防早发型HD方面有益。本研究的目的是回答阿司匹林抵抗是否与复发性HD相关这一问题。

研究设计

在参与“FRUIT-RCT”研究6至16年后，邀请年龄、研究组和慢性高血压情况相匹配的有和没有复发性HD的女性参与这项随访研究。在摄入阿司匹林10天后，使用三种互补检测方法检测阿司匹林抵抗：血小板功能分析仪-200（PFA-200）、VerifyNow检测和血清血栓素B（TXB）检测。采用独立样本t检验、曼-惠特尼U检验、费舍尔精确检验和卡方检验进行统计分析。

结果

24名有复发性HD的女性中有13名参与，24名无复发性HD的女性中有16名参与。根据PFA-200检测，实验室阿司匹林抵抗的患病率为34.5%；根据VerifyNow检测为3.4%；根据TXB检测为24.1%。通过任何一种检测方法得出的阿司匹林抵抗患病率为51.7%。有和没有复发性HD的女性在每项单独检测中的阿司匹林抵抗情况无差异。无论是否使用低分子量肝素，通过任何一种检测方法测得的阿司匹林抵抗在无复发性HD的女性中更常见（p<0.01）。