酚妥拉明与硝苯地平、硫酸镁联合治疗妊娠期高血压患者的临床疗效
Clinical efficacy of combination therapy of phentolamine,nifedipine,and magnesium sulfate in patients with gestational hypertension
王园园 1黄春梅 2索辉 1张萍 1曹妍妍3
作者信息
- 1. 开封一五五医院妇产科,河南 开封 475003
- 2. 联勤保障部队第 988 医院妇产科,河南 郑州 450007
- 3. 开封市人民医院妇科,河南 开封 475003
- 折叠
摘要
目的:探讨酚妥拉明与硝苯地平、硫酸镁联合治疗妊娠期高血压(Hypertension disorder complicating pregnancy,HDCP)患者的临床疗效.方法:选取开封一五五医院 2021年 6 月至2023年 6 月收治的HDCP患者 60 例,随机分为单药组和联合用药组(n=30),分别采用硫酸镁(初始剂量 2.5～4 g,静脉注射,维持剂量 1～2 g·h-1,静脉滴注)以及酚妥拉明(10 mg·次-1,1 次·d-1,静脉滴注)联合硝苯地平缓释片(20 mg·次-1,2次·d-1,口服)、硫酸镁治疗.治疗 1 w后,比较两组临床疗效,采用医用电子血压计测定患者的舒张压、收缩压,彩色多普勒超声诊断仪测定患者的脐动脉血流搏动指数(Pulsatility index,PI)、脐动脉收缩/舒张末期血流速度比值(Systolic velocity/diastolic velocity,S/D)、阻力指数(Resistance index,RI),采用酶联免疫法检测患者的血管内皮功能指标胎盘生长因子(Placenta growth factor,PLGF)、可溶Fms样酪氨酸激酶-1(Soluble Fms-like tyrosine kinase-1,sFlt-1),采用双抗体夹心法检测患者的内皮素-1(Endothelin-1,ET-1)及一氧化氮水平;分娩后,比较两组的母婴结局.结果:联合用药组临床总有效率高于单药组(P＜0.05);治疗后,联合用药组舒张压、收缩压、PI、S/D、RI、血清ET-1、sFlt-1 水平均低于单药组,血清PLGF、一氧化氮水平均高于单药组(P＜0.05);联合用药组不良母婴结局总发生率低于单药组(P＜0.05).结论:酚妥拉明与硝苯地平、硫酸镁联合治疗HDCP具有较好的临床疗效,可有效调节患者的血压,修复血管内皮损伤,改善患者的脐动脉血流,改善母婴结局.
Abstract
Objective:To investigate the clinical efficacy of phentolamine combined with nifedipine and magnesium sulfate in treating hypertension disorder complicating pregnancy(HDCP).Methods:A total of 60 HDCP patients admitted to Kaifeng 155th Hospital from June 2021 to June 2023 were collected and randomly divided into a single drug group and a combined drug group(n=30),treated with magnesium sulfate(initial dose 2.5-4 g,intravenous injection,maintenance dose 1-2 g·h-1,intravenous infusion),and phentolamine(10 mg·time-1,1 time·d-1,intravenous infusion)combined with nifedipine sustained-release tablets(20 mg·time-1,2 times·d-1,orally),and magnesium sulfate,respectively.After 1 week of treatment,the clinical efficacy was compared between the two groups,the diastolic pressure and systolic pressure were measured by medical electronic sphygmomanometer,umbilical artery blood flow pulsatility index(PI),systolic velocity/diastolic velocity(S/D)and resistance index(RI)were measured by color Doppler ultrasonography,vascular endothelial function indexes placenta growth factor(PLGF)and soluble Fms-like tyrosine kinase-1(sFlt-1)were detected by enzyme-linked immunoassay,endothelin-1(ET-1)and nitric oxide were detected by double-antibody sandwich method.After delivery,the maternal and infant outcomes were compared between the two groups.Results:The total effective rate of the combined drug group was higher than that of the single drug group(P<0.05).After treatment,the diastolic blood pressure,systolic blood pressure,PI,S/D,RI,and serum levels of ET-1 and sFlt-1 in the combined drug group were lower than those in the single drug group.In contrast,the serum levels of PLGF and nitric oxide were higher than those in the single drug group(P<0.05).The total incidence of adverse maternal and infant outcomes in the combined drug group was lower than that in the single drug group(P<0.05).Conclusion:Phentolamine combined with nifedipine and magnesium sulfate in the treatment of HDCP has a good clinical effect,which can effectively regulate the blood pressure of patients,repair vascular endothelial injury,improve the umbilical artery blood flow of patients,and improve the outcome of maternal and infant.
关键词
妊娠期高血压/酚妥拉明/硝苯地平缓释片/硫酸镁/临床疗效Key words
Hypertension disorder complicating pregnancy/Phentolamine/Nifedipine sustained release tablets/Magnesium sulfate/Clinical effect引用本文复制引用
出版年
2024
NETL
NSTL
万方数据