硝酸甘油对妊高征母脐血血清NO_2^-/NO_3^-及围生儿预后的影响  

Effects of nitroglycerin on maternal and umbilical serum nitrite/nitrate and the prognosis of neonates in pregnancy-induced hypertension syndrome

作　　者：徐洪斌[1] 徐宏里[1] 魏晓萍[1] 杨斌[1] 

机构地区：[1]暨南大学医学院附属二院妇产科,深圳518020

出　　处：《中国实用妇科与产科杂志》2003年第9期545-547,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的　研究硝酸甘油对妊高征母、脐血清NO2 /NO3 及围生儿预后的影响。方法　选取 1999～ 2 0 0 0年晚期妊娠正常妇女 (正常组Ⅰ组 :12例 ) ,中、重度妊高征患者 36例 [妊高征组 ,其中单用硫酸镁 (Mg)治疗Ⅱ组 :12例 ;单用硝酸甘油 (Ng)治疗Ⅲ组 :12例 ;联合用药 (Mg +Ng)治疗Ⅳ组 :12例 ]。采用硝酸还原酶法测母、围生儿脐血清NO2 /NO3 ,并对围生儿预后进行评价。结果　母血NO2 /NO3 浓度 :产前PIH组低于Ⅰ组 ,差异有显著性意义 (P <0 0 5 ) ,产后各组差异无显著性意义 ;脐静脉血各组NO2 /NO3 浓度均小于产前 ,但PIH组与Ⅰ组比较 ,脐血间差异小于母血间差异 ,用药后Ⅲ、Ⅳ组上升 ,差异有显著性意义 (P <0 0 5 ) ,Ⅱ组差异无显著性意义 (P >0 0 5 )。围生儿预后不良者百分率 ,PIH组比Ⅰ组增高 ,但差异无显著性意义 (P >0 0 5 ) ,PIH组间差异无显著性意义 (P >0 0 5 )。结论　硝酸甘油作为NO供体治疗妊高征时 ,能改变母、脐血NO含量 ,从而降低胎儿 -胎盘循环阻力 ,可能对PIH引起的胎儿宫内发育迟缓 (IUGR)Objective To study the effects of nitroglycerin on maternal and umbilical serum level of nitrite/nitrate and the prognosis of neonates in pregnancy-induced hypertension syndrome (PIH).Methods Twelve normal pregnancy cases were taken as control (Group Ⅰ);thirty-six moderate to severe PIH patients were equally divided into three groups according to medical treatment.Group Ⅱ was treated only with magnesium sulfate (Mg),Group Ⅲ only with nitroglycerin (Ng),and Group Ⅳ with Mg and Ng. Results Antepartum serum levels of nitrite/nitrate (NO 2 /NO 3 ) in PIH groups decreased significantly compared with that in Group Ⅰ (P<0 05),while postpartum levels showed no significant difference between the four groups;levels of NO 2 /NO 3 dropped in postpartum umbilical serum in all groups,but between PIH groups and Group Ⅰ,the difference in umbilical cord was less than that in maternal serum;after medical treatment,the umbilical levels in Group Ⅲ and Ⅳ increased significantly (P<0 05),while Group Ⅱ showed no significant change.The percentage of unfavorable neonatal prognosis was higher in PIH groups than that in Group Ⅰ,but without any significance (P>0 05).Conclusion Ng can improve maternal-umbilical NO concentration when used for treating PIH patients.It may have therapeutic effect on PIH-induced fetal intrauterine growth retardation by reducing the fetus-placenta circulation resistance.

关 键 词：硝酸甘油 妊高征 母脐血 血清NO2^-/NO3^ 围生儿 预后 影响 

分 类 号：R714.246[医药卫生—妇产科学]