尼莫地平及硫酸镁对重度妊娠高血压综合征的治疗效果及其对血内皮素、一氧化氮的影响  

The Effects of Nimodipine and Magnesium Sulfate on Plasma Endotheline and Serum Nitric Oxide in Patients with Severe Pregnancy Induced Hypertension

作　　者：苟文丽[1] 郭红[1] 宋青[1] 

机构地区：[1]交通大学第一医院妇产科,西安710061

出　　处：《中华围产医学杂志》2003年第2期78-81,共4页Chinese Journal of Perinatal Medicine

摘　　要：目的　探讨尼莫地平及硫酸镁对重度妊娠高血压综合征 (简称妊高征 )的治疗效果及其对血浆内皮素 (ET)、血清一氧化氮 (NO)的影响 ,为临床治疗提供理论依据。　方法　将 4 2例重度妊高征随机分为两组 ,给予尼莫地平或硫酸镁治疗 ,观察治疗前后血压、眼底动脉、尿蛋白、内皮素、一氧化氮代谢产物 (NO2 -与 NO3- )及临床症状 ,比较妊娠结局。　结果　 (1)尼莫地平治疗后 ,患者血清NO2 - 与 NO3- 水平明显升高 ,自 (5 1.72± 14 .6 4 )μmol/ L升至 (6 7.5 6± 14 .77)μmol/ L (P<0 .0 5 ) ,血浆 ET水平自 (94 .5 6± 2 5 .0 6 ) ng/ L降至 (84 .4 1± 2 5 .72 ) ng/ L (P<0 .0 5 ) ,ET/ NO比值自 1.91±0 .4 9下降至 1.30± 0 .4 8(P<0 .0 5 ) ;经硫酸镁治疗后血浆 ET水平虽有明显下降 (P<0 .0 5 ) ,但血清NO2 - 与 NO3- 无明显增加 ,ET/ NO比值无显著性变化 (P>0 .0 5 )。 (2 )用药后血压明显下降时间 :尼莫地平组 (0 .5 h)较硫酸镁组 (2 h)快。 (3)患者自觉症状消失时间 :尼莫地平组 [(1.7± 1.3) h]较硫酸镁组快 [(3.4± 1.7) h]。　结论　尼莫地平与硫酸镁相比有较强的改善和保护内皮细胞功能 ,降压迅速持久 ,扩张脑血管作用强 ,临床自觉症状改善快 ,除心率加快外无其他副反应。Objective To explore the therapeutic effects of nimodipine and magnesium sulfate on severe pregnancy induced hypertension (PIH) as well as the effect on plasma endotheline (ET) and serum nitric oxide (NO), in order to provide theoretical foundation for clinical treatment. Methods Forty two patients with severe PIH, being divided into 2 groups at random, were treated with nimodipine or magnesium sulfate. The changes of blood pressure, arteriole of eyeground, urine protein, ET, NO and clinical symptoms were observed respectively before and after the treatment, and the pregnancy outcomes were compared. Results (1) After the treatment of nimodipine, the serum NO of patients increased significantly from (51.72±14.64)μmol/L to (67.56±14.77)μmol/L ( P <0.05), and plasma endotheline declined from (94.56±25.06)ng/L to (84.41±25.72)ng/L ( P <0.05), the ET/NO ratio descended from 1.91±0.49 to 1.30±0.48( P <0.05). After the treatment of magnesium sulfate, plasma ET level decreased significantly ( P <0.05), but serum NO was not enhanced obviously, and there were no remarkable changes in ET/NO ratio ( P >0.05). (2) The nimodipine group took shorter time (0.5 h) to lower the blood pressure notably than the magnesium sulfate group (2 h).(3) As for the disappearing of subjective symptoms , nimodipine group (1.7± 1.3) h was quicker than magnesium sulfate group (3.4±1.7) h. Conclusions Compared with magnesium sulfate, nimodipine was better in improving and protecting the function of endotheline cells, dilating cerebral blood vessels, depressing blood pressure strongly and persistently, reducing subjective symptoms of patients and had no other side effects except increasing heart rate.

关 键 词：尼莫地平 硫酸镁 妊娠高血压 内皮素 一氧化氮 

分 类 号：R714.246[医药卫生—妇产科学]