尼莫地平联合硫酸镁对中重度妊娠期高血压孕妇的临床研究  

Clinical trial of nimodipine combined with magnesium sulfate in the treatment of pregnant women with moderate and severe pregnancy induced hypertension

作　　者：麦扬青[1] 王丽 戴小萍[2] MAI Yang-qing;WANG Li;DAI Xiao-ping(Department of Reproductive Medicine Center,The First Affiliated Hospital of Hainan Medical University,Haikou 570102,China;Department of Gynaecology,Hainan Traditional Chinese Medicine Hospital,Haikou 570203,China)

机构地区：[1]海南医学院第一附属医院生殖医学中心,海口570102 [2]海南省中医院妇产科,海口570203

出　　处：《中国临床药理学杂志》2018年第22期2591-2593,共3页The Chinese Journal of Clinical Pharmacology

基　　金：海南省自然科学基金资助项目(1426360.10A1006)

摘　　要：目的观察尼莫地平联合硫酸镁对中重度妊娠期高血压疾病孕妇血清和肽素、皮质醇的影响。方法选取中重度妊娠期高血压孕妇78例,随机分为试验组和对照组,各39例。对照组给予25%硫酸镁注射液60 m L+葡萄糖500m L,静脉滴注,每天1次;试验组在对照组的基础上给予尼莫地平片35 mg,每天2次,持续治疗至分娩。治疗前后收集血液标本测定血清和肽素、皮质醇、内皮素-1(ET-1)、一氧化氮(NO)浓度,比较2组患者的临床疗效,记录2组孕产妇妊娠结局和药物不良发应发生情况。结果治疗后,对照组有效率为76. 92%(30例/39例),试验组为94. 87%(37例/39例),差异有统计学意义(P <0. 05)。试验组顺产率为61. 54%(24例/39例),对照组为38. 46%(15例/39例),差异有统计学意义(P <0. 05)。治疗后,对照组和试验组血清皮质醇分别为(310. 36±30. 18),(281. 20±27. 45) nmol·L^(-1),血清和肽素分别为(1. 97±0. 61),(1. 48±0. 59)μg·L^(-1),血清ET-1分别为(73. 51±12. 26),(54. 17±11. 09) ng·L^(-1),血清NO分别为(714. 53±86. 67),(924. 55±102. 34)nmol·L^(-1),差异均有统计学意义(均P <0. 05)。对照组并发症发生率为35. 90%(14例/39例),试验组为发生率12. 82%(5例/39例),差异有统计学意义(P <0. 05)。结论尼莫地平与硫酸镁联用有助于改善中重度妊娠期高血压孕妇的妊娠结局,降低血清和肽素、皮质醇浓度,改善血管内皮功能,安全性高。Objective To observe the effect of nimodipine combined with magnesium sulfate in the treatment of pregnant women with moderate and severe pregnancy induced hypertension on serum copeptin and corti- sol. Methods Seventy - eight pregnant women with moderate and se- vere gestational hypertension were randomly divided into treatment group and control group, 39 cases in each group. Control group was given 25% magnesium sulfate injection 60 mL ＋ glucose 500 mL, qd. Treatment group was given nimodipine tablets 35 mg, bid, on the basis of control group. Two groups were treated until delivery. Blood samples were collected before and after treatment to detect serum concentration of copeptin, cortisol, endothelin - 1 （ ET - 1 ） and nitric oxide （NO）, the clinical efficacy in two groups were compared. The pregnancy outcomes and complications in two groups were recorded. Results After treatment, the total effective rates in control group and treatment group were 76.92% （30 cases/39 cases） ,94. 87% （37 cases/39 cases）, with statistical difference（ P 〈 0. 05）. The rates of spontaneous delivery in treatment group and control group were 61.54% （24 cases/39 cases）, 38.46% （ 15 cases /39 cases）, with statistical difference（P 〈 0. 05 ）. After treatment, the serum cortisol in control group and treatment group were （310.36±30. 18）, （281.20 ±27.45） nmol·L^-1 serum copeptin were （ 1.97±0.61 ） , （ 1.48±0.59 ） μg·L^-1, serum ET-1 were （73.51 ±12.26）, （54. 17 ±11.09） ng·L^-1, serum NO were （714.53±86. 67）, （924.55± 102.34） nmol·L^-1, all with significant difference（all P 〈0. 05）. The incidence of complications in control group and treatment group were 35.90% （ 14 cases/39 cases）, 12.82% （5 cases/39 cases）, with statistical difference（P 〈0. 05 ）. Conclusion Nimodipine combined with magnesium sulfate can improve the pregnancy outcome of pregnant women with moderate and severe gestational hypertension, reduce the concentration of serum copep

关 键 词：尼莫地平 硫酸镁 中重度妊娠期高血压 和肽素 皮质醇 血管内皮功能 

分 类 号：R97[医药卫生—药品]