Preventive effect of low-dose aspirin on preeclampsia occured in preeclampsia high-risk pregnant women and its mechanism / 吉林大学学报(医学版)

ABSTRACT

Objective: To observe the preventive effect of low-dose aspirin (LDA) in the preeclampsia (PE) high-risk pregnant women, and to elucidate the feasibility and clinical value of LDA in preventing PE. Methods: A total of 112 PE high-risk pregnant women with 16-22 gestational weeks were selected and randomly divided into control group (n = 5 8) and observation group (n = 5 4). The patients in control group were given placebo treatment, the patients in observation group were given 75 mg • d-1 LDA before going to bed until delivery. The incidence of PE, gestational age of onset, gestational age of delivery, neonatal birth weight, delivery mode, neonatal outcomes of the patients in two groups were observed. The patients in two groups were divided in to PE (+) (with PE) group and PE (-) (without PE) group according to whether PE occured or not. The coagulation function and the platelet parameters of the patients in two groups were detected; the levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), thromboxane A2 (TXA2), P-selectin in placenta tissue of the patients in two groups were detected by ELISA method. Results: Compared with control group, the incidence of PE and the incidence of premature delivery of the patients in observation group were significantly decreased (P < 0. 05); the gestational age of delivery of the patients in observation group were prolonged (P < 0. 05), the neonatal birth weight was increased (P < 0. 01), and the full-term birth rate was increased (P < 0. 01). Compared with the PE (+) and PE (-) patients in control group, the prothrombin time (PT) and activated partial thromboplastin time (APTT) of the PE (-) patients in observation group were increased (P < 0. 01), and the PT of the PE (+) patients in observation group was decreased (P < 0. 01); the levels of prothrombin activity (P T A), fibrinogen (FIB) and D-dimer (D-D) of the PE (+) and PE (-) patients in observation group were decreased. Compared with control group, the levels of IL-6, TNF-αa, COX-2, TXA2 and P-selectin in placenta tissue of the patients in observation group were decreased significantly (P < 0. 01). Conclusion: LDA treatment within 16 - 22 weeks of gestation can effectively prevent the occurrence of PE in the PE high-risk pregnant women, its mechanism is related to improving the coagulation function and inhibiting the protein expressions of inflammatory factors in the PE high-risk pregnant women.