摘要
目的 探讨高压氧联合尼莫地平治疗妊娠期高血压孕妇的临床疗效及作用机制.方法 选取2020年7月至2021年5月临沂市人民医院产科收治的妊娠期高血压患者98例作为研究对象.按照随机数字表法将98例患者分为观察组及对照组,每组49例.对照组患者给予尼莫地平静脉注射及口服治疗,观察组患者在对照组治疗的基础上联合高压氧治疗.比较2组患者治疗后的临床疗效、血压水平、妊娠结局、不良反应发生情况.采用酶联免疫吸附法检测2组患者治疗前后血清T-bet及妊娠相关血浆蛋白-A(PAPP-A)水平.结果 观察组患者治疗后临床总有效率明显高于对照组(x2=4.018,P=0.025);观察组患者治疗后收缩压、舒张压及血清T-bet、PAPP-A水平明显低于对照组(P＜0.01);观察组患者剖宫产、新生儿窒息、胎心异常发生率明显低于对照组(P＜0.05或P＜0.01),新生儿Apgar评分高于对照组(P＜0.05);2组患者治疗过程中不良反应发生率比较差异无统计学意义(P＞0.05).结论 高压氧联合尼莫地平治疗能提高妊娠期高血压孕妇的临床总有效率,降低血压水平,改善妊娠结局,且不增加不良反应发生率;其作用机制可能与降低血清T-bet及PAPP-A水平有关.
Abstract
Objective To investigate the clinical efficacy and mechanism of action of hyperbaric oxygen(HBO)therapy combined with nimodipine in the treatment of gestational hypertension in pregnant women.Methods A total of 98 pregnant women with gestational hypertension admitted to the Department of Obstetrics of Linyi People's Hospital from July 2020 to May 2021 were selected as the study subjects.They were divided into an observation group and a control group according to the random number table method,with 49 cases in each group.The patients in the control group were given treatment with intravenous injection and oral administration of nimodipine,while the patients in the observation group received HBO therapy in addition to the treatments of the control group.The clinical efficacy,blood pressure,pregnancy outcome,and occurrence of adverse reactions were compared between the two groups.Enzyme-linked immunosorbent assay was used to detect the levels of serum T-bet and pregnancy-associated plasma protein-A(PAPP-A)before and after treatment in both groups.Results The clinical total effective rate of the observation group was significantly higher than that of the control group(x2=5.018,P=0.025).The diastolic blood pressure(DBP),systolic blood pressure(SBP),and levels of serum T-bet and PAPP-A in the observation group were significantly lower than those in the control group after treatment(P＜0.01).The incidence of cesarean section,neonatal asphyxia,and fetal heart abnormality in the observation group were significantly lower than those in the control group(P＜0.05 or P＜0.01).The Apgar score of newborns in the observation group was higher than that in the control group(P＜0.05).There was no statistically significant difference in the occurrence of adverse reactions between the two groups during treatment(P＞0.05).Conclusion HBO therapy combined with nimodipine can improve the clinical total effective rate in the treatment of gestational hypertension in pregnant women,reduce blood pressure,improve pregnancy outcome,but not increase the incidence of adverse reactions.Its mechanism of action may be related to the down regulation of levels of serum T-bet and PAPP-A.
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