硫酸镁联合硝苯吡啶对妊娠期高血压疾病的治疗效果及对妊娠相关蛋白A、血液流变学的影响  

Effects of magnesium sulfate combined with nifedipine on hypertensive disorder complicating pregnancy and its effects on pregnancy associated plasma protein A and hemorheology

作　　者：龚淑芬 李雪莲 宋志红 GONG Shu -fen;LI Xue - lian;SONG Zhi - hong(Department of Obstetrics and Gynecology,Dachuan District People＇s Hospital ,Dazhou Sichuan 635000 ,P. R. Chin)

机构地区：[1]达川区人民医院妇产科,四川达州635000

出　　处：《中国计划生育和妇产科》2018年第7期85-89,共5页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的观察硫酸镁联合硝苯吡啶对妊娠期高血压疾病的临床疗效及对妊娠相关蛋白A(pregnancy associated plasma protein A,PAPP-A)、血液流变学的影响。方法选择2014年12月至2016年12月达州市达川区人民医院收治的妊娠期高血压疾病患者345例,根据入院先后顺序分为观察组(173例)和对照组(172例)。对照组患者采用25%硫酸镁静脉滴注,控制每日硫酸镁摄入量为25~30 g,观察组在对照组治疗基础上口服硝苯吡啶片,10 mg/次,Q 8 H,连续治疗5~7 d。观察两组患者治疗前后血压、血流动力学指标、PAPP-A、总抗氧化能力(total antioxidant capacity,TAC)、血管内皮功能水平变化情况。结果治疗前,两组患者血压、血液流变学指标水平比较差异无统计学意义(P>0.05)。治疗1个疗程后,观察组血压、全血黏度(高切、中切、低切)和全血还原黏度(高切、中切、低切)水平均低于对照组(P<0.05)。治疗前,两组PAPP-A、TAC、血管内皮生长因子(vascular endothelial growth factor,VEGF)、内皮素(endothelin,ET)、一氧化氮(nitric oxide,NO)水平比较差异无统计学意义(P>0.05)。治疗1个疗程后,观察组PAPP-A、VEGF、ET水平低于对照组,TAC、NO水平高于对照组(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论硫酸镁联合硝苯吡啶治疗妊娠期高血压疾病可有效降低血压,改善血液流变学水平和血管内皮功能,降低血清PAPP-A水平,且不增加不良反应,安全性较高。Objective To observe the clinical curative effect of magnesium sulfate combined nifedipine on hypertensive disorder complicating pregnancy（HDCP） and on pregnancy associated plasma protein A （PAPP- A） and the hemorheology. Methods 345 patients with HDCP treated in Dachuan District People＆ Hospital from December 2014 to December 2016 were divided into the control group（ 172 cases） and the observation group （173 cases） according to the order of admission. The control group were treated by intravenous infusion of 25 % magnesium sulfate, magnesium sulfate daily intake of 25 - 30 g. The observation group were treated withoral nifedipine tablets on the basis of treatment in the control group, 10 mg each time, Q8H, continuous treatment for 5 -7 days. The changes of blood pressure, hemodynamic parameters, PAPP - A, total antioxidant capacity （TAC） and vascular endothelial function before and after treatment were observed in both groups. Results Before treatment, there was no significant difference in blood pressure and hemorheology indexes between the two groups （P 〉 0. 05 ）. After one course of treatment, the blood pressure, whole blood viscosity （high cut, middle cut, low cut） and whole blood reduced viscosity （high cut, middle cut, low cut） in the observation group were lower than those in the control group （ P 〈 0. 05 ）. Before treatment, the levels of PAPP - A, TAC, vascular endothelial growth factor （VEGF）, endothelin （ET）, and nitric oxide （NO） were not significantly different between the two groups （P 〉 0. 05 ）. After one course of treatment, the levels of PAPP - A, VEGF, and ET were lower in the observation group than in the control group, and the levels of TAC and NO were higher in the observation group than in the control group （ P 〈 0. 05 ）. There was no significant difference in the incidence of adverse reactions between the two groups（ P 〉 0. 05 ）. Conclusion Magnesium sulfate combined with nifedipine in the treatment of HDCP can effecti

关 键 词：硫酸镁 硝苯吡啶 妊娠期高血压疾病 血液流变学 内皮功能 

分 类 号：R714.24[医药卫生—妇产科学]