硫酸镁硝苯地平片联合地西泮对重度子痫前期患者血压血清sEng sFlt-1水平和妊娠结局的影响

doi:10.3969/j.issn.1006-6233.2020.08.015

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摘要 目的: 探究硫酸镁、硝苯地平片(Nf)联合地西泮对重度子痫前期(S-PE)患者血压、血清可溶性内皮因子(sEng)、可溶性血管内皮生长因子受体1(sFlt-1)水平和妊娠结局的影响。方法: 选取2018年6月至2019年6月我院收治的160例S-PE患者进行研究, 按简单随机数字表法以1:1比例分为对照组与研究组, 每组各80例。对照组患者使用硫酸镁+Nf进行治疗, 研究组患者则在对照组基础上加用地西泮进行治疗。对比两组治疗1周后临床疗效, 治疗前、治疗1周后24h血压情况[收缩压(SBP)、舒张压(DBP)]、血清指标(sEng、sFlt-1)差异, 并记录妊娠结局及治疗期间药物不良反应发生情况。结果: 治疗1周后, 研究组总有效率为92.50%, 显著高于对照组81.25%(P<0.05)。治疗1周后, 两组患者24h SBP、24h DBP, 血清sEng、sFlt-1水平较治疗前均显著降低, 且研究组患者上述指标与同期对照组对比差异显著(P<0.05)。追访患者妊娠结局, 研究组患者妊娠结局优于对照组(P<0.05);且治疗期间研究组患者药物不良反应率显著低于对照组(P<0.05)。结论: 对于重度子痫前期患者, 应用硫酸镁、硝苯地平片联合地西泮进行治疗, 可有效改善患者血压、缓解血管内皮损伤, 改善妊娠结局, 且安全性较高, 有较好的应用价值。

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关键词 ：重度子痫前期, 硫酸镁, 硝苯地平, 地西泮, 血压, 妊娠结局

Abstract：Objective: To explore the effects of magnesium sulfate, nifedipine tablets (Nf) combined with diazepam on blood pressure, serum soluble endoglin (sEng) and soluble vascular endothelial growth factor receptor 1 (sFlt-1) and pregnancy outcomes in patients with severe preeclampsia (S-PE). Methods: A total of 160 S-PE patients admitted to our hospital from June 2018 to June 2019 were selected for study. They were divided into control group and study group in a 1: 1 ratio according to the simple random number table method, with 80 cases in each group. Patients in control group were treated with magnesium sulfate + Nf while patients in study group were additionally given diazepam on the basis of control group. The clinical efficacy after 1 week of treatment and 24h blood pressure [systolic blood pressure (SBP), diastolic blood pressure (DBP)] and serum indicators (sEng, sFlt-1) before treatment and 1 week after treatment were compared between the two groups, and the pregnancy outcomes and occurrence of adverse drug reactions during treatment were recorded. Results: 1 week after treatment, the total effective rate in study group was significantly higher than that in control group(92.50% vs 81.25%) (P<0.05). The levels of 24h SBP and 24h DBP, serum sEng and sFlt-1 in the two groups were significantly decreased compared with those before treatment, and the above indicators in study group were significantly different from those in control group at the same period (P<0.05). The pregnancy outcome follow-up revealed that in study group it was better than in control group (P<0.05). The adverse drug reaction rate in study group was significantly lower than that in control group during treatment (P<0.05). Conclusion: For patients with severe preeclampsia, the application of magnesium sulfate, nifedipine tablets combined with diazepam can effectively improve the blood pressure, alleviate vascular endothelial damage and promote pregnancy outcomes, and it has higher safety and better application value.

Key words： Severe preeclampsia Magnesium sulfate Nifedipine Diazepam Blood pressure Pregnancy outcomes

基金资助:湖北省卫生健康委科研项目, (编号:WJ2017F041)

通讯作者: 刘久英

引用本文:

王红, 杨雯, 周燕, 李玉霞, 刘久英, 刘久英. 硫酸镁硝苯地平片联合地西泮对重度子痫前期患者血压血清sEng sFlt-1水平和妊娠结局的影响[J]. 河北医学, 2020, 26(8): 1296-1299.
WANG Hong, YANG Wen, ZHOU Yan, et al. Effects of Magnesium Sulfate, Nifedipine Tablets Combined with Diazepam on Blood Pressure SEng and SFlt-1 and Pregnancy Outcomes in Patients with Severe Preeclampsia. HeBei Med, 2020, 26(8): 1296-1299.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2020.08.015 或 http://www.hbyxzzs.cn/CN/Y2020/V26/I8/1296