拉贝洛尔联合低分子肝素治疗妊娠期高血压疾病患者疗效的临床研究  

Clinical trial of labetalol combined with low molecular weight heparin in the treatment of patients with hypertensive disorders in pregnancy

作　　者：朱筱丹 郑秀娟[2] 叶丽燕 王杭英 ZHU Xiao-dan;ZHENG Xiu-juan;YE Li-yan;WANG Hang-ying(Department of Obstetrics,Jinhua Maternal and Child Health Hospital,Jinhua 321000,Zhejiang Province,China;Department of Obstetrics,Jinhua Central Hospital,Jinhua 321000,Zhejiang Province,China)

机构地区：[1]金华市妇幼保健院产科,浙江金华321000 [2]金华市中心医院产科,浙江金华321000

出　　处：《中国临床药理学杂志》2023年第24期3566-3570,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的 探讨拉贝洛尔联合低分子肝素治疗妊娠期高血压疾病(HDP)患者的疗效。方法 HDP患者分为对照组和试验组。对照组口服拉贝洛尔100 mg治疗,q12 h,试验组在对照组的基础上皮下注射低分子肝素4 000 U,qd,均用药至分娩前1 d。比较2组治疗前和治疗2周后收缩压(SBP)、舒张压(DBP)、血浆凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(Fib)、D-二聚体(D-D)水平、胎儿脐血流动脉收缩期最高血流速度与舒张期最低血流速度比值(S/D),终止妊娠前24 h尿蛋白(24 h-PRO)、血清血管内皮细胞增殖的胎盘生长因子(PLGF)、可溶性血管内皮生长因子受体-1(sFlt-1)水平及安全性评价和妊娠结局。结果 试验组和对照组分别纳入29例和33例。治疗后,试验组和对照组的总有效率分别为93.10%(27例/29例)和72.73%(24例/33例),差异有统计学意义(P<0.05);治疗后,试验组和对照组的S/D分别为1.61±0.18和1.73±0.19,SBP分别为(102.35±8.64)和(119.47±9.90)mmHg,DBP分别为(80.34±4.67)和(71.24±4.29)mmHg,Fib分别为(3.11±0.36)和(3.87±0.39)g·L^(-1),D-D水平分别为(1.32±0.40)和(1.75±0.53)mg·L^(-1),PT分别为(13.05±0.71)和(11.92±0.89)s,TT分别为(18.95±1.80)和(16.83±1.94)s,24 h-PRO分别为(1.19±0.05)和(2.35±0.07)g,血清sFlt-1水平分别为(1 528.05±102.33)和(1 901.92±131.47)pg·mL^(-1),血清PLGF观察指标分别为(149.33±12.19)和(125.68±9.17)pg·mL^(-1),试验组上述指标与对照组比较,差异均有统计学意义(均P<0.05);试验组和对照组的胎儿宫内窘迫、胎盘早剥、早产、新生儿窒息发生率分别为9.09%、3.03%、12.12%、6.06%和24.14%、20.69%、31.03%、27.59%,差异均有统计学意义(均P<0.05);试验组的药物不良反应主要有头痛头晕3例、恶心呕吐1例、失眠2例,对照组的药物不良反应主要有头痛头晕2例、恶心呕吐1例、失眠1例。试验组和对照组的总药物不良反应发生率分别为20.69%和12.12%,差异无统计学意义(Objective To explore the curative effect of labetalol combined with low molecular weight heparin on hypertensive disorders in pregnancy(HDP).Methods HDP patients were divided into control group and treatment group.The control group was treated with labetalol100 mg orally,q12 h,and the treatment group was subcutaneously injected with low molecular weight heparin 4 000 U,qd,on the basis of the control group.Both groups were treated until 1 d before delivery.The systolic blood pressure(SBP),diastolic blood pressure(DBP),plasma prothrombin time(PT),thrombin time(TT),fibrinogen(Fib),D-dimer(D-D),peak systolic velocity/end diastolic velocity(S/D),24 h urinary protein(24 h-PRO),serum placental growth factor(PLGF),soluble vascular endothelial growth factor receptor-1(sFlt-1),safety evaluation and pregnancy outcomes were compared between the two groups before and after 2 weeks of treatment.Results The treatment group and the control group included 29 and 33 cases,respectively.After treatment,the total effective rates in treatment group and control group were 93.10%(27 cases/29cases),72.73%(24 cases/33 cases),with statistical difference(P <0.05).After treatment,the S/D of treatment group and control group were 1.61±0.18 and 1.73±0.19;SBP were(102.35±8.64) and(119.47±9.90)mmHg,DBP were(80.34±4.67) and(71.24±4.29) mmHg;Fib were(3.11±0.36) and(3.87±0.39)g ·L^(-1);D-D levels were(1.32±0.40) and(1.75±0.53) mg · L^(-1);PT were(13.05±0.71) and(11.92±0.89) s;TT were(18.95±1.80) and(16.83±1.94) s;24 h-PRO were(1.19±0.05) and(2.35±0.07) g;serum sFlt-1 levels were(1 528.05±102.33) and(1 901.92±131.47) pg · mL^(-1);the serum PLGF observation indexes were(149.33±12.19) and(125.68±9.17) pg·mL^(-1),respectively,and there were statistically significant differences between the treatment group and the control group(all P <0.05).The incidence of fetal distress,placental abruption,premature delivery and neonatal asphyxia in treatment group and control group were 9.09%,3.03%,12.12%,6.06% and 24.14%,20.69%,31.03%,27.59%,

关 键 词：拉贝洛尔 低分子肝素 妊娠期高血压疾病 血管内皮细胞增殖的胎盘生长因子 可溶性血管内皮生长因子受体-1 

分 类 号：R97[医药卫生—药品]