高压氧辅助治疗妊娠期高血压患者的疗效及对血浆NO、ET-1、SOD和MDA水平的影响  

Efficacy of hyperbaric oxygen as an adjuvant therapy for patients with pregnancy induced hypertension and the influence on serum NO,ET-1,SOD,and MDA levels

作　　者：姚霞[1] 王霞[1] 陈旺香 李娜[1] 陈爱香 李晓苗[3] Yao Xia;Wang Xia;Chen Wangxiang;Li Na;Chen Aixiang;Li Xiaomiao(Department of Obstetrics,Heji Hospital Affiliated to Changzhi Medical College,Shanxi 046000,China;Department of Nursing,Changzhi Medical College,Shanxi 046000,China;Department of Gynecology,Heji Hospital Affiliated to Changzhi Medical College,Shanxi 046000,China)

机构地区：[1]长治医学院附属和济医院产科,长治046000 [2]长治医学院护理系,长治046000 [3]长治医学院附属和济医院妇科,长治046000

出　　处：《中华航海医学与高气压医学杂志》2024年第5期664-668,673,共6页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的评估高压氧(HBO)辅助治疗妊娠期高血压的效果,并探究对患者血浆一氧化氮(NO)、内皮素-1(ET-1)、超氧化物歧化酶(SOD)及丙二醛(MDA)水平的影响。方法选取2019年1月至2023年1月于长治医学院附属和济医院产科治疗的80例妊娠期高血压患者为研究对象,按照随机数字表法分为研究组和对照组各40例。对照组在常规治疗基础上联合硫酸镁注射,研究组在对照组基础上予以HBO辅助治疗,均连续治疗10 d。比较2组患者治疗前后血压,24 h尿蛋白含量,凝血功能,血浆NO、ET-1、SOD和MDA水平,妊娠及胎儿结局。结果研究组的临床总有效率(97.50%)高于对照组(85.00%),差异有统计学意义(P<0.05)。治疗后,研究组收缩压[(134.75±10.02)mmHg]、舒张压[(88.04±4.93)mmHg]和24 h尿蛋白含量[(7.04±1.05)g]均明显低于对照组[(148.01±11.86)mmHg、(95.17±5.52)mmHg和(8.83±1.26)g],凝血酶时间[(12.81±0.63)s]、凝血酶原时间[(11.65±1.60)s]和活化部分凝血活酶时间[(28.14±3.03)s]明显长于对照组[(11.40±0.58)s、(9.74±1.52)s、(25.61±2.77)s],纤维蛋白原水平[(4.25±0.37)g/L]明显低于对照组[(5.01±0.48)g/L],NO[(78.14±8.21)μmol/L]和SOD[(102.46±17.98)U/ml]均明显高于对照组[(65.11±6.79)μmol/L、(87.40±15.63)U/ml],ET-1[(89.64±8.34)ng/L]和MDA[(12.36±1.33)μmol/L]均明显低于对照组[(98.63±8.78)ng/L、(15.21±1.87)μmol/L],差异均有统计学意义(P<0.05);治疗后,研究组患者子痫(2.50%)、胎盘早剥(5.00%)、剖宫产(22.50%)、产后出血(2.50%)发生率均明显低于对照组[15.00%、30.00%、55.00%、20.00%],胎儿宫内窘迫(35.00%)、胎儿宫内发育迟缓(27.50%)、早产(20.00%)和新生儿窒息(5.00%)发生率也明显低于对照组[57.50%、50.00%、42.50%、22.50%],差异均有统计学意义(P<0.05)。结论HBO辅助治疗妊娠期高血压有利于降低孕妇血压水平,减轻蛋白尿症状,改善凝血功能,还可调节血管内皮功能及氧化应激反应,减少不良母婴结Objective To evaluate the therapeutic effect of hyperbaric oxygen(HBO)as an adjuvant therapy on patients with pregnancy induced hypertension(PIH),and investigate the influence on serum nitric oxide(NO),endothelin-1(ET-1),superoxide dismutase(SOD),and malondialdehyde(MDA)levels.Methods Eighty patients with PIH who were treated in the Department of Obstetrics of Heji Hospital Affiliated to Changzhi Medical College from January 2019 to January 2023 were selected as the study subjects.They were divided into study group and control group by the random number table method,with 40 patients in each group.The control group was treated with magnesium sulfate on the basis of conventional treatment,while the study group was treated with HBO on the basis of the treatments for control group.All patients underwent 10 days of continuous treatment.The two groups were compared in terms of blood pressure,24-hour urine protein quantification,coagulation function,serum NO,ET-1,SOD,and MDA levels,pregnancy outcomes,and fetal outcomes.Results After treatment,the total effective rate of the study group(97.50%)was higher than that of the control group(85.00%),with a statistically significant difference(P<0.05).After treatment,systolic blood pressure[(134.75±10.02)mmHg],diastolic blood pressure[(88.04±4.93)mmHg],and 24-hour urine protein content[(7.04±1.05)g]in the study group were significantly lower than those in the control group[(148.01±11.86)mmHg,(95.17±5.52)mmHg,and(8.83±1.26)g](P<0.05).After treatment,thrombin time[(12.81±0.63)s],prothrombin time[(11.65±1.60)s],and activated partial thromboplastin time[(28.14±3.03)s]in the study group were obviously longer than those in the control group[(11.40±0.58)s,(9.74±1.52)s,and(25.61±2.77)s].Fibrinogen level[(4.25±0.37)g/L]was significantly lower than that in the control group[(5.01±0.48)g/L](P<0.05).After treatment,the levels of NO[(78.14±8.21)μmol/L]and SOD[(102.46±17.98)U/ml]in the study group were significantly higher than those in the control group[(65.11±6.79)μmol/L,

关 键 词：高压氧 妊娠期高血压 一氧化氮 内皮素?1 超氧化物歧化酶 丙二醛 妊娠结局 胎儿结局 

分 类 号：R714.246[医药卫生—妇产科学]