首页|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

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

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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.
Clinical efficacy of combination therapy of phentolamine,nifedipine,and magnesium sulfate in patients with gestational hypertension
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.

Hypertension disorder complicating pregnancyPhentolamineNifedipine sustained release tabletsMagnesium sulfateClinical effect

王园园、黄春梅、索辉、张萍、曹妍妍

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开封一五五医院妇产科,河南 开封 475003

联勤保障部队第 988 医院妇产科,河南 郑州 450007

开封市人民医院妇科,河南 开封 475003

妊娠期高血压 酚妥拉明 硝苯地平缓释片 硫酸镁 临床疗效

2024

四川生理科学杂志
四川省生理科学会

四川生理科学杂志

影响因子:0.575
ISSN:1671-3885
年,卷(期):2024.46(6)