硫酸镁下调未足月子痫前期产妇外周血胱抑素C水平和随机尿蛋白与尿肌酐比值的临床效果及安全性评价  

Clinical effect and safety evaluation of down-regulation of cystatin C levels in peripheral blood and random urine protein/urine creatinine ratio by magnesium sulfate in preterm preeclampsia

作　　者：任丽萍 季寒冰 

机构地区：[1]上海市长宁区妇幼保健院,上海200051

出　　处：《中国妇幼保健》2017年第13期2872-2876,共5页Maternal and Child Health Care of China

摘　　要：目的研究未足月子痫前期(PE)经硫酸镁治疗后随机尿蛋白与尿肌酐比值(Upro/Ucr)和外周血胱抑素C(Cys C)水平的变化。探讨未足月PE应用硫酸镁治疗的临床效果和安全性。方法选取2013年5月-2016年1月上海市长宁区妇幼保健院确诊治疗的未足月PE患者136例纳入研究组(轻度子痫前期75例,重度子痫前期61例),选择同期住院的80例健康孕妇作为对照组。所有患者于治疗前测量随机Upro/Ucr及外周血Cys C水平,研究组给予硫酸镁治疗后再次测定其随机Upro/Ucr及外周血Cys C水平,并分析应用硫酸镁治疗的临床效果和安全性。结果经硫酸镁治疗前,研究组未足月PE患者的随机Upro/Ucr和Cys C水平高于对照组,重度未足月PE患者的随机Upro/Ucr和Cys C水平高于轻度未足月PE患者,差异均有统计学意义(P<0.05)。经硫酸镁治疗后,重度未足月PE患者的随机Upro/Ucr和Cys C水平较治疗前明显下降(P<0.05)。轻度未足月PE患者的剖宫产率、产后出血、新生儿阿氏评分等较对照组差异无统计学意义(P>0.05)。重度未足月PE患者的临床疗效和妊娠结局有显著改善。研究组未足月PE患者在治疗过程中无药物过量和明显不良反应发生。结论硫酸镁能够明显降低重度未足月PE患者的随机Upro/Ucr和Cys C水平,改善肾功能及临床疗效和妊娠结局,且无明显不良反应发生。Objective To research the changes of random urine protein/urine creatinine ratio（Upro/Ucr） and cystatin C levels in peripheral blood after treatment with magnesium sulfate in preterm preeclampsia patients,explore the clinical effect and security of magnesium sulfate.Methods A total of 136 preterm preeclampsia patients（study group） diagnosed and treated in the hospital from May 2013 to January 2016 were selected and divided into mild preeclampsia group（75 patients） and severe preeclampsia group（61 patients）,eighty healthy pregnant women during the same period were selected as control group.Random Upro/Ucr and cystatin C levels in peripheral blood were measured before treatment among all the patients.The patients in study group were treated with magnesium sulfate,then random Upro/Ucr and cystatin C levels in peripheral blood were measured again,the clinical effect and security of magnesium sulfate were analyzed.Results Before treatment,random Upro/Ucr and cystatin C levels in peripheral blood in study group were higher than those in control group,random Upro/Ucr and cystatin C levels in peripheral blood in severe preeclampsia group were higher than those in mild preeclampsia group,there were statistically significant differences（P〈 0.05）.After treatment,random Upro/Ucr and cystatin C levels in peripheral blood in severe preeclampsia group were statistically significantly lower than those before treatment（P0.05）.There was no statistically significant difference in cesarean section rate,postpartum hemorrhage,and neonatal Apgar score between mild preeclampsia group and control group（P0.05）.The clinical effect and pregnancy outcome of severe preeclampsia patients were improved significantly.No drug overdose and adverse reactions occurred during the treatment course in study group.Conclusion Magnesium sulfate can significantly reduce random Upro/Ucr and cystatin C levels in peripheral blood and improve kidney function,clinical curative effect,and pregnancy outcome of preterm severe preeclam

关 键 词：硫酸镁 子痫前期 胱抑素C 随机尿蛋白与尿肌酐比值 

分 类 号：R714.21[医药卫生—妇产科学]