摘要
目的:探究硝苯地平、酚妥拉明联合硫酸镁对妊高症(Pregnancy induced hypertension syndrome,PIH)高危患者肾脏血流动力学、血压及血管内皮因子水平的影响。方法:回顾性分析我院2017年8月至2019年8月期间收治的113例PIH高危患者的临床资料,根据治疗方法不同分为对照组和观察组,对照组患者(n=56)给予硫酸镁1-2 g•h-1静滴治疗,观察组(n=57)联合口服硝苯地平240 mg以及静滴酚妥拉明10μg•min-1治疗。对比两组患者治疗10 d后的疗效及血压变化;采用酶联免疫吸附法测定血浆内皮素-1(Endothelin-1,ET-1)水平,硝酸还原法测定血浆一氧化氮(Nitric oxide,NO)水平,采用彩色多普勒超声检测肾脏血流动力学参数:阻力指数(Resistent index,RI)、搏动指数(Pulsatility index,PI)、收缩期流速峰值(Peak systolic velocity,PSV)、舒张末期的流速峰值(Peak end diastolic velocity,EDV)以及收缩期/舒张期值(Systole/Diastole,S/D);同时记录不良反应以及随访4 m末的妊娠结局。结果:观察组患者治疗总有效率明显高于对照组(P<0.05);两组患者治疗10 d末收缩压、舒张压、血浆ET-1水平及PI、RI、S/D水平均明显降低(P<0.05),其中观察组低于对照组(P<0.05);血浆NO水平及EDV、PSV水平均明显升高(P<0.05),且观察组高于对照组(P<0.05);观察组异常妊娠率明显低于对照组(P<0.05),总不良反应率低于对照组(P<0.05)。结论:硝苯地平、酚妥拉明联合硫酸镁调控PIH高危患者血管内皮功能及血流动力学水平,药物安全性好,改善母婴结局。
Objective:To investigate the effects of nifedipine and phenolamine combined with magnesium sulfate on blood pressures,vascular endothelial factor levels and renal hemodynamics of pregnancy induced hypertension syndrome(PIH)patients.Methods:Clinical data of 113 high-risk PIH patients admitted to our hospital from August 2017 to August 2019 were retrospectively analyzed.According to different treatment methods,all patients were divided into control group and observation group.Patients in control group(n=56)were treated with 1-2 g•h-1 magnesium sulfate intravenous drip,and patients in observation group(n=57)were treated with nifedipine 240 mg orally and 10μg•min-1 intravenous drip of phenolamine.The therapeutic effect and blood pressure changes after 10 days of treatment were compared between the two groups.Plasma endothelin-1(ET-1)levels were determined by Enzym-linked immunosorbentassay,plasma Nitric oxide(NO)levels were determined by Nitric acid reduction method,and renal hemodynamic parameters including resistance index(RI),pulsatility index(PI),peak systolic velocity,resistance index(RI),pulsatility index(PI),peak systolic velocity(PSV),peak end diastolic velocity(EDV)and systole/diastole(S/D)values were determined by color Doppler ultrasound.Adverse reactions were recorded and pregnancy outcomes at the end of 4 m were followed up.Results:The total effective rate in the observation group was significantly higher than that in the control group(P<0.05).At the end of 10 days after treatment,systolic blood pressure,diastolic blood pressure,plasma ET-1 level and PI,RI,S/D levels were decreased in both groups,while those in the observation group were lower than those in the control group.The plasma levels of NO,EDV and PSV were higher in the observation group than in the control group(P<0.05).The abnormal pregnancy rate and total adverse reaction rate in the observation group were lower than that in the control group(P<0.05).Conclusion:Nifedipine and phentolamine combined with magnesium sulfate regulate vascular endothelial function and hemodynamic level in high-risk patients with PIH,with good drug safety and improved maternal and infant outcomes.
作者
祝冬梅
Zhu Dong-mei(Department of Obstetrics,Nanyang First People's Hospital,Nanyang 473000,Henan,China)
出处
《四川生理科学杂志》
2021年第4期590-593,共4页
Sichuan Journal of Physiological Sciences
关键词
硝苯地平
酚妥拉明
硫酸镁
妊高症
血压
Nifedipine
Phentolamine
Magnesium sulfate
PIH
Blood pressure
