血清雌三醇、孕酮联合测定监测硝酸甘油静脉注射治疗先兆早产的临床研究  

The clinic study of monitoring intravenous glyceryl trinitrate treating threatened preterm through assaying sermn estratriol and progesterone

作　　者：熊金玲[1] 张建军[1] 

机构地区：[1]孝感市中心医院,湖北孝感432000

出　　处：《健康大视野（医学版）》2007年第1期15-17,共3页Health Horizon:Medical Science Fascicule

摘　　要：目的观察硝酸甘油静脉注射治疗先兆早产的临床效果。测定雌三醇（E3）、孕酮（P）的变化，探讨其作用机理。方法102例先兆早产患者随机分为硫酸镁加硫酸舒喘灵常规治疗组55例，和静脉注射硝酸甘油组47例。两组孕妇治疗前后分别抽取外周静脉血，采用放射免疫分析法测定血清中E3，电化学发光法测定血清中P水平。观察两组孕妇用药前后复查E3、P的变化及治疗效果，以及分娩启动先兆早产与E3、P的关系。结果①硝酸甘油组：先兆早产孕妇在24h内宫缩消失，有效率91．48％。延长至37w分娩的孕妇为93．69％。治疗后宫缩消失时间（20．19±10．64）h。硫酸镁加硫酸舒喘灵组：先兆早产孕妇在72h内宫缩消失，有效率89．09％。延长至37w分娩的孕妇为83％。治疗后宫缩完全消失时间（58.95±25.28）h。硝酸甘油组延长先兆早产孕妇孕期效果明显优于硫酸镁组（P〈0.01）。②硝酸甘油组孕妇血浆中E3水平由治疗前的（76．72±44．86）ng／L，显著下降至治疗后的（67．14±35．47）ng／L。两组比较，差异有显著性（P〈0．05）。硫酸镬组孕妇血浆中E3水平治疗前（77．67±36.17）ng/L，治疗后上升为（87．66±35．58）ng/L。差异无显著性（P〉0．05）。③硝酸甘油组孕妇血浆中P水平治疗前（106．23±40．17）ng／L，明显上升至治疗后的（115．66±41．33）ng／L。硫酸镁组孕妇血浆中P水平治疗前（107．78±38．25）ng／L，治疗后显著上升为（120.8±39．27）n∥L，差异有极显著性（P〈0．01）。结论先兆早产与E3水平的增高，孕酮水平的降低有关。硝酸甘油静脉注射后，孕妇血中E3水平降低，孕酮水平增高。达到治疗先兆早产的目的。硝酸甘油静脉注射是一种安全有效的抗早产药物。Objective To observe the clinic effect of treating threatened preterm through intravenous glyceryl trinitrate, assay the change of estratrioleand progesterone and explore its action mechanism.Methods We depart 102 cases of gravida with tbreatened preterm into two groups. 55cases accept the common treatment - magnesium sulfate and albuterol sulfate. 47cases accept another treatment - intravenous glyceryl trinitrate. In two groups, we hemospasia from periphery vein before and after treatment, Then adopt radio - immuno to assay serum estratriol and electrochemical luminescence to assay serum progesterone. We observe the change of estratriol and progesterone before and after treatment. The effect of treatment, the relationship between,initiating labor,thereatened preterm and estravtriol,progesterone,Results In glyceryl trinitrate group. The uterine constraction of gravida with threatened preterm disappear in 24 hours, The effective rate is 91.48 %. The gravidas prolong to 37weeks occupy 93.6%. After treatment the time of uterine constraction＇s complete, disappearing is 20.19 ± 10.64. In magnesium sulfate and albuterol sulfate,uterine constraction of gravida with threatened preterm disappear in 72hours, The effective rate is 89.09%. The gravidas prolong to 37weeks occupy 83 %. After treatment the time of uterine constraction＇ s complete disappearing is 58.95 ± 25.28, The effect of prolonging the time of pregnancy in threatened preterm in glyceryl group is better than in magnesiun sulfate group dramatically（ P 〈 0.01）. In glyceryl group the serum estratriol decrease dramatically from（76.72±44.86ng/L） before treatment to （67.14±35.47ng/L） after treatwent. The disparity is dramatical （ P 〈 0.05）. In magnesium sulfate group the serum estratriol increase from 77.67±36.17ng/L before treatment to 87.66±35.58ng/L after treatment. The disparity is not dramatical（ P 〉 0.05）.In glyceryl group, the serum progesterone increase dramatcally from 106.23 ±40.17ng/L before treatmeat to 165.66±41.35

关 键 词：先兆早产 硝酸甘油 雌三醇 孕酮 

分 类 号：R714.45[医药卫生—妇产科学]