盐酸拉贝洛尔注射液联合硫酸镁注射液治疗子痫前期患者的临床研究

Clinical trial of labetalol hydrochloride injection combined with magnesium sulfate injection in the treatment of patients with preeclampsia

目的观察拉贝洛尔联合硫酸镁对子痫前期患者血清高迁移率族蛋白B1(HMGB-1)、铁蛋白、血管内皮素水平的影响。方法将我院收治的子痫前期患者102例,随机分为试验组和对照组,各51例。2组均给予常规治疗,对照组用硫酸镁注射液治疗,首次静脉滴注,5%葡萄糖100 m L+25%硫酸镁20 m L,30 min内滴注完成,每天1次;之后静脉滴注5%葡萄糖500 m L+25%硫酸镁60m L,速度1~2 g·h^-1,每天1次,持续用药到分娩。试验组在对照组基础上给予盐酸拉贝洛尔注射液50 mg+5%葡萄糖250 m L,每天1次;待患者血压维持在140/90 mm Hg,且临床症状平稳后,可口服拉贝洛尔,每次50~100 mg,每天3次,持续用药到分娩。比较2组HMGB1、铁蛋白及血管内皮素水平,观察血压、心率变化及妊娠结局。结果治疗后,试验组与对照组的HMGB1分别为(1.86±0.30)和(3.63±0.36)mg·L^-1,铁蛋白分别为(31.91±2.20)和(34.19±2.13)μg·L^-1,血管内皮素分别为(242.57±20.16)和(377.67±28.10)pmol·L^-1,舒张压(DBP)分别为(80.01±2.43)和(91.60±2.41)mm Hg,收缩压(SBP)分别为(132.65±3.74)和(148.29±3.79)mm Hg,心率分别为(81.67±1.75)和(86.88±1.78)times·min^-1,差异均有统计学意义(均P<0.05)。试验组出现胎儿窘迫1例,早产1例,产后出血1例,无宫缩乏力、新生儿窒息及产后感染,妊娠并发症总发生率为5.88%(3例/51例);对照组出现宫缩乏力4例,胎儿窘迫5例,早产3例,新生儿窒息4例,产后出血4例,产后感染5例,妊娠并发症总发生率为49.02%(25例/51例),差异有统计学意义(P<0.05)。结论拉贝洛尔联合硫酸镁治疗子痫前期患者可明显降低HMGB-1、铁蛋白及血管内皮素水平,能改善患者妊娠结果。

Objective To observe the effect of labetalol hydrochloride injection combined with magnesium sulfate injection on serum high mobility group B1(HMGB-1),ferritin and endothelin in patients with preeclampsla.Methods A total of 102 patients with preeclampsia were randomly divided into treatment group and control group.Two groups were given conventional treatment,while control group was treated with magnesium sulfate,5%glucose 100 m L+of 25%magnesium sulfate 20m L,intravenous infusion within 30 min,once a day.After that,5%glucose 500 m L+25%magnesium sulfate 60 m L was injected intravenously at a rate of 1-2 g·h^-1,1 time a day,and continued until delivery.Treatment group was given labetalol 50 mg+5%glucose 250 m L on the basis of control group,once a day.After the patients’blood pressure maintained at 140/90 mm Hg and the clinical symptoms were stable,labetalol can be taken orally,50-100 mg each time,three times a day,and continued until delivery.The levels of HMGB1,ferritin and endothelin in two groups were compared,and blood pressure,heart rate and pregnancy outcome were observed.Results After treatment,the levels of HMGB1 in treatment group and control group were(1.86±0.30),(3.63±0.36)mg·L^-1,ferritin were(31.91±2.20),(34.19±2.13)mu·L^-1,endothelin were(242.57±20.16),(377.67±28.10)pmol·L^-1,diastolic blood pressure(DBP)was(80.01±2.43),(91.60±2.41)mm Hg,systolic blood pressure(SBP)were(132.65±3.74),(148.29±3.79)mm Hg,heart rates were(81.67±1.75)and(86.88±1.78)times·min^-1,all with significant differences(all P<0.05).In treatment group,there were 1 case of fetal distress,1 case of premature delivery,1 case of postpartum hemorrhage,no uterine weakness,neonatal asphyxia or postpartum infection,the total incidence of pregnancy complications was 5.88%(3 cases/51 cases).There were 4 cases of uterine weakness,5 cases of fetal distress,3 cases of premature delivery,4 cases of neonatal asphyxia,4 cases of postpartum hemorrhage and 5 cases of postpartum infection in control group,the total incidence of pregnancy complications was 49.02%(25 cases/51 cases),with significant difference(P<0.05).Conclusion In the treatment of preeclampsia patients,rabelol combined with magnesium sulfate can significantly reduce the levels of HMGB-1,ferritin and endothelin,which can improve the pregnancy outcome of patients.