硫酸镁治疗妊娠期高血压综合征患者的临床研究  

Value of magnesium sulfate in the treatment of pregnancy-induced hypertension

作　　者：徐晖 冼妮[2] 甘昌鑫[3] 宋玉琼[2] XU Hui;XIAN Ni;GAN Chang-xin;SONG Yu-qiong(Department of Obstetrics,Xianning Central Hospital,Xianning 437100,Hubei Province,China;Department of Gynecology,the First Affliated Hospital ofGuangxi Universityof Chinese Medicine,Nanning 530000,Guangxi Zhuang Autonomous Region,China;Laboratory Department,the First Affliated Hospital ofGuangxi Universityof Chinese Medicine,Nanning 530000,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]湖北咸宁市中心医院产科,湖北咸宁437100 [2]广西中医药大学第一附属医院妇科,广西壮族自治区南宁530000 [3]广西中医药大学第一附属医院检验科,广西壮族自治区南宁530000

出　　处：《中国临床药理学杂志》2023年第20期2900-2904,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的 基于胎盘血流灌注和抗氧化能力变化探究硫酸镁治疗妊娠期高血压综合征(PIH)患者的价值。方法 将PIH患者按随机数字表法分为对照组和试验组。对照组给予硝苯地平缓释片,每次10 mg,每天3次,口服;试验组在对照组的基础上给予硫酸镁,首次给予25%硫酸镁注射液5 g+10%葡萄糖注射液20 mL,静脉推注,而后以硫酸镁注射液15 g+5%葡萄糖注射液500 mL静脉滴注,并根据血压变化调整滴速,其速度控制在1~1.5 g·h^(-1),2组患者均治疗7 d。比较2组患者的治疗疗效及治疗前后胎盘血流灌注指标[脐动脉收缩压与舒张压比值(S/D)、阻力指数(RI)、搏动指数(PI)]和抗氧化能力指标[丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)、总抗氧化能力(TAC)]。根据临床疗效将试验组分为痊愈组、有效组及无效组,比较不同临床疗效患者治疗前后胎盘血流灌注和抗氧化能力指标,分析各指标与临床疗效的相关性及对临床疗效的评估价值;比较不同妊娠结局患者的胎盘血流灌注和抗氧化能力指标,分析各指标变化对患者妊娠结局的影响。结果 对照组和试验组各196例。试验组和对照组治疗总有效率分别为87.24%和78.57%,差异有统计学意义(P<0.05)。治疗后,试验组和对照组的PI分别为2.24±0.21和2.36±0.19;RI分别为0.75±0.07和0.79±0.10;S/D值分别为2.40±0.19和2.58±0.21;MDA水平分别为(23.88±2.74)和(25.05±3.16)μmol·L^(-1);TAC水平分别为(9.83±0.62)和(9.51±0.57)U·mL^(-1),2组比较差异均有统计学意义(均P<0.05)。痊愈组治疗前后PI、RI、S/D、MDA、TAC水平的差值均大于有效组,且有效组均大于无效组(均P<0.05)。治疗前后PI、RI、S/D、MDA、TAC差值与硫酸镁治疗疗效呈正相关(均P<0.05)。结论 硫酸镁治疗PIH可改善患者胎盘血流灌注及抗氧化能力,且患者胎盘血流灌注及抗氧化能力变化与临床疗效相关,并可用于评估硫酸镁对PIH的治疗疗效。Objective To explore the value of magnesium sulfate in the treatment of pregnancy-induced hypertension (PIH) based on the changes of placental blood perfusion and antioxidant capacity.MethodsPatients with PIH were divided into control group and treatment group by the random number table method.The control group was given oral administration of nifedipine sustained-release tablets (10 mg a time,3times a day),and the treatment group was given magnesium sulfate(intravenous infusion with 25%magnesium sulfate injection 5 g+10%glucose injection 20 m L,and then intravenous infusion with magnesium sulfate injection 15 g+5%glucose injection 500 m L,and the infusion rate was adjusted according to blood pressure changes and the rate was controlled within 1-1.5 g·h^(-1)).Both groups of patients were treated for 7 days.The therapeutic efficacy,placental blood perfusion indicators[ratio of umbilical artery systolic to diastolic pressure (S/D),resistance index (RI),pulsatility index (PI)]and antioxidant capacity indicators[malondialdehyde (MDA),glutathione peroxidase (GSH-Px),total antioxidant capacity (TAC)]before and after treatment were compared between the two groups.According to clinical efficacy,the patients in treatment group were classified into cured group,effective group and ineffective group.The indicators of placental blood perfusion and antioxidant capacity were compared among patients with different clinical efficacy before and after treatment,and the correlation between each indicator and clinical efficacy and the evaluated value on clinical efficacy were analyzed.The indicators of placental blood perfusion and antioxidant capacity were compared among patients with different pregnancy outcomes,and the effects of the changes of each indicator on pregnancy outcomes were analyzed.Results There were 196 cases in each group.The total effective rates in treatment group and control group were 87.24%and78.57%,the difference was statistical significant (P0.05).After treatment,PI in treatment group and control group were

关 键 词：硫酸镁 妊娠期高血压综合征 胎盘血流灌注 抗氧化能力 

分 类 号：R97[医药卫生—药品]