不同剂量低分子肝素联合硝苯地平治疗重度子痫前期的疗效及其对患者氧化应激的影响  

Effect of different doses of low molecular weight heparin combined with nifedipine on the treatment of severe preeclampsia and its efffect on oxidative stress in patients

作　　者：胡玉霞[1] 张秀俊[1] 李晓茜 邓冉冉 王春霞 HU Yu-xia;ZHANG Xiu-jun;LI Xiao-qian;DENG Ran-ran;WANG Chun-xia(Department of Obstetrics,Handan First Hospital,Handan 056000,Hebei,China)

机构地区：[1]邯郸市第一医院产科,河北邯郸056000

出　　处：《川北医学院学报》2025年第3期358-361,共4页Journal of North Sichuan Medical College

基　　金：河北省邯郸市科学技术研究与发展计划项目(23422083268)。

摘　　要：目的:探讨不同剂量低分子肝素联合硝苯地平治疗重度子痫前期的疗效及对患者氧化应激的影响。方法:选取102例重度子痫前期产妇为研究对象,根据治疗方法不同分为大剂量组(LD组)和小剂量组(SD组),每组各51例。两组产妇均在常规治疗基础上使用低分子肝素联合硝苯地平治疗,其中SD组使用小剂量低分子肝素(2 500 U/次);LD组使用大剂量低分子肝素(5 000 U/次),疗程均为1周。比较两组产妇临床疗效、氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)和蛋白质氧化产物(AOPP)]及胎盘缺氧细胞因子[胎盘生长因子(PLGF)、妊娠相关血浆蛋白A(PAPP-A)和可溶性内皮因子(sEng)]水平及妊娠结局。结果:LD组产妇临床总有效率高于SD组(92.16%vs.76.47%,P<0.05)。治疗前,两组产妇氧化应激及胎盘缺氧细胞因子水平无统计学差异(P>0.05)。治疗1周后,两组产妇SOD、GSH-Px、PLGF及PAPP-A水平均升高(P<0.05),且LD组高于SD组(P<0.05);MDA、AOPP和sEng均降低(P<0.05),且LD组低于SD组(P<0.05)。LD组产妇不良妊娠结局发生率低于SD组(11.76%vs.29.41%,P<0.05)。结论:不同剂量低分子肝素联合硝苯地平对重度子痫前期的疗效不同,大剂量低分子肝素有利于提高临床疗效,改善氧化应激和胎盘缺氧状态,降低不良妊娠发生率。Objective:To analyze the effect of different doses of low molecular weight heparin combined with nifedipine on severe preeclampsia and its effect on oxidative stress in patients.Methods:A total of 102 pregnant women with severe preeclampsia were included and divided into high-dose group(LD group) and low-dose group(SD group) according to different treatment methods,with 51 cases in each group.Both groups were treated with low molecular weight heparin combined with nifedipine on the basis of conventional treatment,among which the SD group was treated with low molecular weight heparin(2,500 U/time).LD group was treated with high dose of low molecular weight heparin(5,000 U/time).After 1 week of treatment,the clinical efficacy,oxidative stress indicators [superoxide dismutase(SOD),malondialdehyde(MDA),glutathione peroxidase(GSH Px),and protein oxidation products(AOPP)],levels of placental hypoxia cytokines [placental growth factor(PLGF),pregnancy associated plasma protein A(PAPP-A),and soluble endothelial factor(sEng)],and pregnancy outcomes were compared between the two groups.Results:The total effective rate of LD group and SD group was 92.16% and 76.47%,respectively,and LD group was higher than SD group(P<0.05).There were no significant differences in oxidative stress level and placental hypoxic cytokine expression between the two groups before treatment(P>0.05).SOD,GSH-Px,PLGF and PAPP-A of the two groups after treatment were higher than those before treatment(P<0.05),and LD group was higher than SD group(P<0.05).After treatment,MDA,AOPP and sEng in two groups were lower than before treatment(P<0.05),and LD group was lower than SD group(P<0.05).The incidence of adverse pregnancy outcomes in LD group and SD group was 11.76% and 29.41%,respectively,and LD group was lower than SD group(P<0.05).Conclusion:Low molecular weight heparin combined with nifedipine can be effectively applied in the treatment of severe preeclampsia,but the efficacy of different doses of low molecular weight heparin is different.Large doses

关 键 词：低分子肝素 硝苯地平 重度子痫前期 氧化应激 胎盘缺氧细胞因子 

分 类 号：R714.245[医药卫生—妇产科学]