硝酸甘油用于妊娠高血压综合征治疗的研究  

Therapeutic effects of nitroglycerin on pregnancy induced hypertension

作　　者：徐洪斌[1] 徐宏里[1] 陈递林[1] 马利国[1] 谢康云[1] 苏放明[1] 

机构地区：[1]暨南大学医学院附属第二医院妇产科,深圳518020

出　　处：《中华妇产科杂志》2001年第7期495-499,共5页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的　探讨硝酸甘油在妊娠高血压综合征 (妊高征 )治疗中的应用价值及其可行性。方法　选择中、重度妊高征患者 3 4例 ;其中单纯用硫酸镁治疗 11例 (硫酸镁组 ) ,单纯用硝酸甘油治疗11例 (硝酸甘油组 ) ,硫酸镁 +硝酸甘油联合用药治疗 12例 (联合用药组 )。另选取正常晚期妊娠妇女11例 (正常妊娠组 )作对照。采用免疫组织化学及图像分析仪测定以上 4组产妇胎盘的内皮型一氧化氮合酶 (eNOS)含量 ,血小板聚集仪检测血小板聚集率 ,彩色多普勒超声检测应用硝酸甘油后脐动脉收缩期及舒张期 (S/D)比值和阻力指数 ,并记录各组应用药物后的血压变化。结果　 ( 1)胎盘eNOS含量 :硫酸镁组为 0 2 4± 0 0 7,硝酸甘油组为 0 2 5± 0 0 8,联合用药组为 0 2 6± 0 0 7,正常妊娠组为0 3 5± 0 0 8。妊高征各组与正常妊娠组比较 ,差异均有极显著性 (P <0 0 1)。 ( 2 )硝酸甘油组用药后 ,脐动脉S/D比值及阻力指数较用药前明显降低 ,用药前后比较 ,差异有显著性 (P <0 0 5 )。 ( 3 )血小板聚集率 :硝酸甘油组、联合用药组用药后明显降低 ,用药前后比较 ,差异有极显著性 (P <0 0 1) ;硫酸镁组则无明显改变。 ( 4 )降压作用 :硫酸镁组用药后 ,血压变化不明显 ;硝酸甘油组及联合用药组 ,用药后血压降低 ,用药前后?Objective To evaluate the effects and possibility of nitroglycerin on Pregnancy induced hypertension (PIH) treatment Methods In comparision with the third trimester normal pregnant women (Normal group) (n=11), 34 moderate/severe PIH cases were divided into three groups: PIH treated only with magnesium sulfate (Mg group) (n=11); PIH treated only with nitroglycerin (Ng group) (n=11); and PIH treated with Mg+ Ng (Combination group) (n=12). The endothelial nitric oxide synthase (eNOS) in placenta was investigatd immunohistochemiscally and quantitatively. Data such as platelet aggregation (PAg), umbilcal artery of S/D ratio and resistance index (RI) with color Doppler and the effect of decrement of blood pressure on PHI groups were evaluated. Results In comparision with Normal group, (1) the quantity of eNOS of PIH cases was signaficently lower (P<001). (2) umbilical artery S/D ratio and RI in Ng group were significanctly lower after introvascular drip of Ng (P<005). (3) Pag in Ng group and Combination group decreased significantly after treatment (P <001), but no difference in Mg group. (4) the decrement of blood pressure on PIH groups, compared with Mg group, was significanct in Ng group and Combination groups (P<005). Conclusions Ng can reduce blood pressure, fetal placenta circulation resistance, and inhibit PAg. It probably play a role on intrauterine growth retardation (IUGR) caused by PIH.

关 键 词：妊娠并发症 心血管 高血压 硝酸甘油 一氧化氮合酶 免疫组织化学 血小板聚集 

分 类 号：R714.246[医药卫生—妇产科学]