硫酸镁与硝苯地平联合治疗妊高症对患者血压水平和母婴结局的影响
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摘要
目的研究硫酸镁与硝苯地平联合治疗妊高症对患者血压水平和母婴结局的影响。方法选取2015年2月至2017年11月厦门市海沧医院收治的98例妊高症患者作为研究对象。按照随机数字表法分为对照组(n=48)和观察组(n=50),观察组接受硝苯地平联合硫酸镁治疗,对照组接受硫酸镁治疗,比较两组患者治疗前后的血压和尿蛋白定量变化、综合治疗效果、药物不良反应及母婴结局。结果两组治疗后收缩压和舒张压较同组治疗前均显著降低,其中观察组治疗后收缩压平均值为(119.7±12.4)mmHg,显著低于对照组收缩压平均值(131.6±12.8)mmHg,观察组治疗后舒张压平均值为(71.8±7.5)mmHg,显著低于对照组舒张压平均值(86.5±8.1)mmHg。两组治疗前尿蛋白含量无显著差异,治疗后尿蛋白含量较同组治疗前均显著降低,其中观察组治疗后尿蛋白含量为(1.12±0.39)g/24h,显著低于对照组尿蛋白含量(1.89±0.41)g/24h。观察组产后并发症发生率为4.00%显著低于对照组产后并发症发生率。观察组1例出现恶心症状,1例出现咳嗽现象,;对照组3例出现呕吐症状,2例出现恶心症状,3例出现咳嗽现象,不良反应发生率为16.67(8/48);观察组患者不良反应发生率为4.00%(2/50),显著低于对照组25.00%(12/48)。观察组患者痊愈人数高于对照组,药物治疗有效率(98.00%)高于对照组(87.50%),结论硫酸镁与硝苯地平联合疗法可以显著改善妊高症患者的血压、尿蛋白定量,并提高临床治疗有效率、降低产后并发症和不良反应发生率,值得继续推广使用。
Objective To investigate the effect of magnesium sulfate combined with nifedipine on the blood pressure and maternal and fetal outcomes in patients with pregnancy-induced hypertension(PIH).Methods A total of 98 patients with PIH who were admitted to our hospital from February 2015 to November 2017 were randomly divided into control group(n=48) and observation group(n=50) according to the random number table method. The observation group received nifedipine combined with magnesium sulfate for treatment, and the control group received magnesium sulfate for treatment. Blood pressure and urinary protein quantitative changes, comprehensive treatment effects, adverse drug reactions, and maternal and fetal outcomes were compared between the two groups before and after treatment.Results Both systolic blood pressure and diastolic blood pressure decreased significantly after treatment in both groups, where the average systolic blood pressure in the observation group was(119.7±12.4) mmHg, significantly lower than the control group of(131.6±12.8)mmHg, and the average diastolic blood pressure in the observation group after treatment was(71.8 ± 7.5) mmHg,significantly lower than the control groupof(86.5 ± 8.1) mmHg. There was no significant difference in urine protein content between the two groups before treatment. The urinary protein level after treatment was significantly lower than before treatment in both groups. The urine protein content in the observation group after treatment was(1.12±0.39) g/24 h, which was significantly lower than that of the control group of(1.89±0.41) g/24 h. The incidence of postpartum complications in the observation group was significantly lower than that in the control group(4.00%). A patient in the observation group had symptoms of nausea and a patient had cough. The control group had vomiting symptoms in 3 cases, nausea symptoms in 2 cases, and coughing in 3 cases. The adverse reaction rate was 16.67(8/48); the observation group patients The incidence of adverse reactions was 4.00%(2/50) in the observation group, which was significantly lower than the control group of 25.00%(12/48). The number of patients recovered in the observation group was larger than that in the control group. The effective rate of drug treatment(98.00%) was higher than that of the control group(87.50%).Conclusions Combination therapy of magnesium sulfate and nifedipine can significantly improve blood pressure and urinary protein in patients with pregnancy-induced hypertension, which can improve the clinical treatment efficiency, reduce the incidence of postpartum complications and adverse reactions, thusly worthy of promotion.
Objective To investigate the effect of magnesium sulfate combined with nifedipine on the blood pressure and maternal and fetal outcomes in patients with pregnancy-induced hypertension(PIH).Methods A total of 98 patients with PIH who were admitted to our hospital from February 2015 to November 2017 were randomly divided into control group(n=48) and observation group(n=50) according to the random number table method. The observation group received nifedipine combined with magnesium sulfate for treatment, and the control group received magnesium sulfate for treatment. Blood pressure and urinary protein quantitative changes, comprehensive treatment effects, adverse drug reactions, and maternal and fetal outcomes were compared between the two groups before and after treatment.Results Both systolic blood pressure and diastolic blood pressure decreased significantly after treatment in both groups, where the average systolic blood pressure in the observation group was(119.7±12.4) mmHg, significantly lower than the control group of(131.6±12.8)mmHg, and the average diastolic blood pressure in the observation group after treatment was(71.8 ± 7.5) mmHg,significantly lower than the control groupof(86.5 ± 8.1) mmHg. There was no significant difference in urine protein content between the two groups before treatment. The urinary protein level after treatment was significantly lower than before treatment in both groups. The urine protein content in the observation group after treatment was(1.12±0.39) g/24 h, which was significantly lower than that of the control group of(1.89±0.41) g/24 h. The incidence of postpartum complications in the observation group was significantly lower than that in the control group(4.00%). A patient in the observation group had symptoms of nausea and a patient had cough. The control group had vomiting symptoms in 3 cases, nausea symptoms in 2 cases, and coughing in 3 cases. The adverse reaction rate was 16.67(8/48); the observation group patients The incidence of adverse reactions was 4.00%(2/50) in the observation group, which was significantly lower than the control group of 25.00%(12/48). The number of patients recovered in the observation group was larger than that in the control group. The effective rate of drug treatment(98.00%) was higher than that of the control group(87.50%).Conclusions Combination therapy of magnesium sulfate and nifedipine can significantly improve blood pressure and urinary protein in patients with pregnancy-induced hypertension, which can improve the clinical treatment efficiency, reduce the incidence of postpartum complications and adverse reactions, thusly worthy of promotion.
引文
[1] Pai C,Yen C,Chen C,et al.Lack of thromboxane synthase prevents hypertension and fetal growth restriction after high salt treatment during pregnancy[J].PLOS ONE,2016,11(3):617-619.
[2] 李介岩,张为远,王欣,等.硫酸镁应用对妊娠期高血压疾病患者胎盘中基质金属蛋白酶-9和水通道蛋白-9表达的影响[J].中华医学杂志,2016,96(30):2421-2423.
[3] 黄静,史霞.硝苯地平联合硫酸镁治疗妊高症的疗效及安全性评价[J].中国组织工程研究,2016,20(2):242-244.
[4] 高宇,折瑞莲,黎燕.硫酸镁联合硝苯地平治疗对妊娠期高血压疾病患者血清Hcy和CRP的影响[J].中国妇幼保健,2014,29(6):859-861.
[5] Al Khaja KAJ,Sequeira RP,Alkhaja AK,et al.Drug treatment of hypertension in pregnancy[J].Journal of Hypertension,2014,32(3):454-463.
[6] Gray C,Li M,Patel R,et al.Let-7 miRNA profiles are associated with the reversal of left ventricular hypertrophy and hypertension in adult male offspring from mothers undernourished during pregnancy after preweaning growth hormone treatment[J].Endocrinology,2014,155(12):4808-4817.
[7] Foo L,Tay J,Lees CC,et al.Hypertension in pregnancy:natural istory and reatment ptions[J].Current Hypertension Reports,2015,17(5):45-47.
[8] 魏晓红,张宇骄,李爱玲,等.硫酸镁联合川芎嗪治疗妊娠期高血压有效性和安全性的Meta分析[J].中国全科医学,2016,19(32):3966-3972.
[9] 王文丽.硫酸镁联合硝苯地平治疗妊娠期高血压疗效分析[J].中国现代医生,2016,54(25):89-91.
[10] 张华兰.硫酸镁联合硝苯地平治疗妊娠期高血压疾病60例临床观察[J].吉林医学,2015,36(01):15-16.
[11] 邱兰,陈玉环,张慧莉,等.硫酸镁联合硝苯地平治疗妊娠期高血压疾病的临床观察[J].齐齐哈尔医学院学报,2016,37(33):4180-4181.
[12] Scantlebury D C,Schwartz G L,Acquah L A,et al.The reatment of ypertension uring regnancy:hen hould lood ressure edications e tarted?[J].Current Cardiology Reports,2013,15(11):34-36.
[13] Khan J,Idrees M.Saudi uidelines on the iagnosis and reatment of ulmonary ypertension:regnancy in pulmonary hypertension[J].Annals of Thoracic Medicine,2014,9(5):108-110.
[14] 赵俊玲.硫酸镁联合硝苯地平及酚妥拉明治疗妊娠期高血压疾病80例临床观察[J].河北北方学院学报(自然科学版),2017,33(08):30-31.
[15] 秦雯.硫酸镁三联用药方案治疗妊娠期高血压疾病疗效观察及对妊娠结局的影响[J].中国妇幼保健,2014,29(26):4230-4232.
[2] 李介岩,张为远,王欣,等.硫酸镁应用对妊娠期高血压疾病患者胎盘中基质金属蛋白酶-9和水通道蛋白-9表达的影响[J].中华医学杂志,2016,96(30):2421-2423.
[3] 黄静,史霞.硝苯地平联合硫酸镁治疗妊高症的疗效及安全性评价[J].中国组织工程研究,2016,20(2):242-244.
[4] 高宇,折瑞莲,黎燕.硫酸镁联合硝苯地平治疗对妊娠期高血压疾病患者血清Hcy和CRP的影响[J].中国妇幼保健,2014,29(6):859-861.
[5] Al Khaja KAJ,Sequeira RP,Alkhaja AK,et al.Drug treatment of hypertension in pregnancy[J].Journal of Hypertension,2014,32(3):454-463.
[6] Gray C,Li M,Patel R,et al.Let-7 miRNA profiles are associated with the reversal of left ventricular hypertrophy and hypertension in adult male offspring from mothers undernourished during pregnancy after preweaning growth hormone treatment[J].Endocrinology,2014,155(12):4808-4817.
[7] Foo L,Tay J,Lees CC,et al.Hypertension in pregnancy:natural istory and reatment ptions[J].Current Hypertension Reports,2015,17(5):45-47.
[8] 魏晓红,张宇骄,李爱玲,等.硫酸镁联合川芎嗪治疗妊娠期高血压有效性和安全性的Meta分析[J].中国全科医学,2016,19(32):3966-3972.
[9] 王文丽.硫酸镁联合硝苯地平治疗妊娠期高血压疗效分析[J].中国现代医生,2016,54(25):89-91.
[10] 张华兰.硫酸镁联合硝苯地平治疗妊娠期高血压疾病60例临床观察[J].吉林医学,2015,36(01):15-16.
[11] 邱兰,陈玉环,张慧莉,等.硫酸镁联合硝苯地平治疗妊娠期高血压疾病的临床观察[J].齐齐哈尔医学院学报,2016,37(33):4180-4181.
[12] Scantlebury D C,Schwartz G L,Acquah L A,et al.The reatment of ypertension uring regnancy:hen hould lood ressure edications e tarted?[J].Current Cardiology Reports,2013,15(11):34-36.
[13] Khan J,Idrees M.Saudi uidelines on the iagnosis and reatment of ulmonary ypertension:regnancy in pulmonary hypertension[J].Annals of Thoracic Medicine,2014,9(5):108-110.
[14] 赵俊玲.硫酸镁联合硝苯地平及酚妥拉明治疗妊娠期高血压疾病80例临床观察[J].河北北方学院学报(自然科学版),2017,33(08):30-31.
[15] 秦雯.硫酸镁三联用药方案治疗妊娠期高血压疾病疗效观察及对妊娠结局的影响[J].中国妇幼保健,2014,29(26):4230-4232.