阿司匹林对妊娠16-24周子宫动脉阻力异常妇女降低子宫动脉阻力的作用

Muhammad Arief Adibrata, A. Sulistyono, E. Ernawati
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摘要

目的:比较16 ~ 24周超声多普勒测速(DV)检查异常、低剂量阿司匹林80 mg/d和125 mg/d的孕妇子宫动脉阻力指数(RI)的下降情况。材料与方法:采用双盲随机临床试验设计。研究对象来自泗水市Mulyorejo和Kalijudan公共卫生服务机构,包括妊娠16-24周子宫动脉速度超声异常的孕妇。超声多普勒检查结果分为4个级别;正常(RI 0.58;(-)舒张缺口),II级(RI 0.58;(+)舒张缺口)。子宫多普勒超声检查在印度尼西亚泗水市埃尔朗加大学医学院妇产科妇产科由妇产科顾问在给予低剂量阿司匹林(125毫克/天和80毫克/天)四周前后进行。结果:获得90例受试者,随机分为2组,每组45例。治疗前,125mg /d组ⅰ级34例,ⅲ级11例。80mg /天组,ⅰ级41例,ⅱ级2例,ⅲ级2例。治疗4周后,阿司匹林125 mg/d组进行第二次DV USG。正常40例,ⅰ级4例,ⅲ级1例。阿司匹林组80mg /天,正常22例,ⅰ级19例,ⅲ级4例。采用Wilcoxon检验分析阿司匹林治疗组(125 mg/d和80 mg/d)治疗前后的差异,p值分别为p=0.001和p=0.005。结论:在16 ~ 24周孕周超声子宫动脉多普勒测速孕妇中,125 mg/d阿司匹林对降低子宫动脉阻力的效果优于80 mg/d阿司匹林。
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Role of aspirin dose in reducing uterine artery resistance in 16-24 weeks pregnant women with abnormal uterine artery resistance
Objectives: To compare the decrease of resistance index (RI) from uterine artery in pregnant woman receiving low dose aspirin therapy between 80 mg/day and 125 mg/day who had abnormal doppler velocimetry (DV) ultrasound examination at 16-24 weeks.Materials and Methods: An experimental study using double blind randomized clinical trial design. Subjects were from Mulyorejo and Kalijudan public health service in Surabaya, that included pregnant women with 16-24 weeks of pregnancy with abnormal uterine artery velocimetry ultrasound. The results of ultrasound Doppler examination were divided into four levels; normal (RI<0.58; (-) diastolic notching), level I (RI> 0.58; (-) diastolic notching), level II (RI<0.58; (+) disatolic notching) and level III (RI> 0.58; (+) diastolic notching). Uterine doppler ultrasound examination was performed at Fetomaternal Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo Hospital, Surabaya, Indonesia, by fetomaternal consultants before and after the admin-istration of low-dose aspirin of 125 mg/day and 80 mg/day for four weeks.Results: Ninety subjects were obtained and randomized into 2 groups, with 45 subject in each group. Before treatment, in 125 mg/day group those with level I were 34 subjects and level III 11 subjects. In 80 mg/day group, level I 41 subjects, level II 2 subjects and level III 2 subjects. After 4 weeks of treatment, a second DV USG was performed in Aspirin 125 mg/day group. Normal were 40 subjects, level I 4 subjects, and level III 1 subject. In aspirin group 80 mg/day, normal 22 subjects, level I 19 subjects and level III 4 subjects. The analysis was performed with Wilcoxon test before and after treatment in both aspirin treatment group 125 mg/day and 80 mg/day with p value respectively, p=0.001 and p=0.005.Conclusion: Compared with aspirin of 80 mg/day, aspirin of 125 mg/day is more superior to decrease uterine arterial resistance in pregnant women with ultrasound uterine arterial doppler velocimetry at 16-24 weeks gestational age.
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