首页|硝苯地平联合盐酸利托君对胎膜早破的疗效及对Toll样受体4、高迁移率族蛋白B1和α1-抗胰蛋白酶的影响

硝苯地平联合盐酸利托君对胎膜早破的疗效及对Toll样受体4、高迁移率族蛋白B1和α1-抗胰蛋白酶的影响

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目的 探究硝苯地平联合盐酸利托君治疗胎膜早破的疗效,以及对血清Toll样受体4(TLR4)、高迁移率族蛋白B1(HMGB1)和α1-抗胰蛋白酶(α1AT)水平的影响.方法 选取2022年10月至2023年10月收治的胎膜早破患者163例,根据不同的给药方式分为观察组(78例,予硝苯地平联合盐酸利托君治疗)和对照组(85例,予盐酸利托君治疗).采用倾向性评分匹配法按1∶1进行匹配后,比较2组的疗效、妊娠延长时间、保胎成功率、新生儿不良结局,以及血清TLR4、HMGB1和α1AT水平,并分析影响疗效的因素.结果 观察组在总有效率、妊娠延长时间、保胎成功率和新生儿不良结局方面均优于对照组(P<0.05).采用广义评估方程评估2组血清TLR4、HMGB1和α1AT水平,结果发现治疗后2组各时间点血清TLR4、HMGB1和α1AT水平均低于治疗前(P<0.05),观察组治疗45 h后血清TLR4、HMGB1和α1AT水平均低于对照组(P<0.05).影响因素分析显示,治疗前血清TLR4<55 ng·mL-1、HMGB1<7.3 ng·mL-1和α1AT<2.75 ng·L-1与治疗有效显著相关(P<0.05).结论 硝苯地平联合盐酸利托君对于胎膜早破的疗效优于单用盐酸利托君,能够延长妊娠时间,提高保胎成功率,改善新生儿不良结局,TLR4、HMGB1和α1AT可能是胎膜早破治疗的潜在靶点.
Efficacy of nifedipine combined with ritodrine hydrochloride in the treatment of premature rupture of membranes based on generalized estimation equation and its influence on serum TLR4,HMGB1 and α1AT levels
AIM To explore the efficacy of nifedipine combined with ritodrine hydrochloride based on generalized estimation equation in the treatment of premature membranes and the effects on serum toll-like receptor 4(TLR4),high mobility group protein B1(HMGB1)and α1-antitrypsin(α1AT)levels.METHODS The study subjects were 163 patients with premature rupture of membranes treated in our hospital from October 2022 to October 2023,who were divided into observation group(78 patients)treated with nifedipine combined with ritodrine hydrochloride and control group(85 patients)treated with ritodrine hydrochloride according to different administration methods.There were 60 pregnant women in both groups after 1∶1 matching with propensity score matching method.The therapeutic effect,extended gestation time,success rate of fetal protection,neonatal outcome,serum TLR4,HMGB1 and α1AT levels were compared in 2 groups after matching.The factors influencing treatment effectiveness were analyzed.RESULTS The observation group was superior to the control group in terms of treatment effect,prolonging pregnancy,success rate of fetal protection and neonatal outcome(P<0.05).The effects of the 2 treatments on serum TLR4,HMGB1 and α1AT levels of pregnant women with premature rupture of membranes were evaluated by generalized evaluation equation.After administration,serum TLR4,HMGB1 and α1AT levels of pregnant women in both groups were decreased(P<0.05),the serum levels of TLR4,HMGB1 and α1AT in observation group were lower than those in control group.The analysis of influencing factors showed that serum TLR4 levels<55 ng·mL-1,HMGB1 levels<7.3 ng·mL-1,and α1AT levels<2.75 ng·L-1 prior to treatment were significantly associated with effective treatment outcomes(P<0.05).CONCLUSION Nifedipine combined with Ritodrine hydrochloride is more resultful in treating premature rupture of membranes,and the serum levels of TLR4,HMGB1 and α1AT are lower.The effect of nifedipine combined with ritodrine hydrochloride on premature rupture of membranes is better than that of ritodrine hydrochloride alone,which can prolong pregnancy and improve the success rate of fetal protection.TLR4,HMGB1 and α1AT may be potential targets for treating premature rupture of membranes.

premature rupture of membranesnifedipine combined with ritodrine hydrochloridetoll-like receptor 4high-mobility group box-1oxidized alpha-1 antitrypsin

田晨光、高静、张家宽

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衡水市第四人民医院产科,衡水 053000

衡水市第四人民医院病区药房,衡水 053000

胎膜早破 硝苯地平 盐酸利托君 Toll样受体4 高迁移率族蛋白B1 α1-抗胰蛋白酶

2024

中国临床药学杂志
中国药学会

中国临床药学杂志

CSTPCD
影响因子:0.502
ISSN:1007-4406
年,卷(期):2024.33(7)