川芎嗪联合低分子肝素钙对妊娠期子痫前期孕妇sFlt-1、VEGF、PLGF、ET-1水平及妊娠结局的影响

Effects of Ligustrazine combined with low molecular weight heparin calcium on levels of sFlt-1,VEGF,PLGF,ET-1 and pregnancy outcome in pregnant preeclampsia patients

目的:探讨妊娠期子痫前期孕妇采用川芎嗪联合低分子肝素钙治疗对其血清可溶性FMS样酪氨酸激酶-1(Soluble fms-like tyrosine kinase-1,sFlt-1)、血管内皮细胞生长因子(Vascular endothelial growth factor,VEGF)、胎盘生长因子(Placental growth factor,PLGF)、内皮素-1(Endothelin-1,ET-1)水平及妊娠结局的影响。方法:选取2022年1月至2023年1月我院收治的102例妊娠期子痫前期孕妇开展前瞻性研究,将102例孕妇随机分为参照组(51例)、联合组(51例)。参照组采用低分子肝素钙治疗,联合组采用低分子肝素钙+川芎嗪治疗。对比两组治疗前后舒张压、收缩压、平均动脉压、24 h尿蛋白定量、血浆D-二聚体(D-dimer,D-D)、纤维蛋白原(Fibrinogen,FIB)、凝血酶时间(Thrombin time,TT)、凝血酶原时间(Prothrombin time,PT)、血清sFlt-1、VEGF、PLGF、ET-1水平,以及两组终止妊娠孕周、新生儿体质量、Apgar评分、新生儿窒息占比。结果:治疗后联合组舒张压、收缩压、平均动脉压、24 h尿蛋白定量、血浆D-D、FIB、血清sFlt-1、ET-1水平低于治疗前、参照组,血浆TT、PT、血清VEGF、PLGF水平高于治疗前、参照组;联合组终止妊娠孕周长于参照组,新生儿体质量、Apgar评分高于参照组(P<0.05);两组新生儿窒息占比差异无统计学意义。结论:川芎嗪联合低分子肝素钙治疗可降低妊娠期子痫前期孕妇血压水平,减少尿蛋白,改善凝血功能,减轻内皮损伤,从而延长孕周、提高新生儿体质量、Apgar评分,可为临床治疗妊娠期子痫前期提供参考依据。

Objective:To investigate the influence of Ligustrazine combined with Low molecular weight heparin calcium treatment on serum fms-like tyrosine kin-1(sFlt-1),vascular endothelial growth factor(VEGF),placental growth factor(PLGF),endothelin-1(ET-1)level and pregnancy outcome in pregnant women with preeclampsia.Methods:A prospective study was conducted in 102 pregnant women with preeclampsia admitted to our hospital from January 2022 to January 2023.They were divided into reference group(51 cases)and combination group(51 cases)randomly.The reference group was treated with low molecular weight heparin calcium,and the combination group was treated with low molecular weight heparin calcium and Ligustrazine.Diastolic blood pressure,systolic blood pressure,mean arterial pressure,24 h urinary protein,Ddimer(D-D),fibrinogen(FIB),thrombin time(TT),prothrombin time(PT),serum sFlt-1,VEGF,PLGF,ET-1 levels,gestational age of termination,neonatal body mass,Apgar score and neonatal asphyxia ratio were compared between the two groups before and after treatment.Results:After treatment,the levels of diastolic blood pressure,systolic blood pressure,mean arterial pressure,24 h urinary protein quantity,plasma D-D,FIB,serum sFlt-1 and ET-1 in combination group were lower than those before treatment and in reference group;while the levels of plasma TT,PT,serum VEGF and PLGF were higher than those before treatment and in reference group,the gestational circumference of the combination group was higher than that of the control group,and the body mass and Apgar score of the newborn were higher than those of the control group(P<0.05).However,there was no significant difference in the proportion of neonatal asphyxia between the two groups.Conclusion:The treatment of Ligustrazine combined with low molecular weight heparin calcium can reduce the blood pressure level of pregnant women with preeclampsia,reduce urinary protein level,improve coagulation function,and alleviate endothelial injury,so as to prolong gestational age,improve newborn body weight and Apgar score,which can provide reference for clinical treatment of preeclampsia during pregnancy.