口服小剂量葡萄糖酸镁预防妊高征的观察

Oral Low Dose Magnesium Gluconate Preventing Pregnancy Induced Hypertension

目的：研究小剂量葡萄糖酸镁预防妊高征的疗效及其机理。方法：采用前瞻性随机双盲的方法，对５１例孕妇（治疗组，其中治疗１组正常孕妇２２例，治疗２组高危孕妇２９例）自孕２８周起，连续服用小剂量葡萄糖酸镁（镁剂），每日３ｇ至分娩；５１例（对照组，其中对照１组正常孕妇２８例，对照２组高危孕妇２３例）按上法服葡萄糖粉（安慰剂）。结果：治疗组妊高征发生率为４％，显著低于对照组的１６％；治疗２组较对照２组前列环素的代谢物（６－ｋｅｔｏ－ＰＧＦ１α）含量及其与血栓素Ａ２的代谢物ＴＸＢ２的比值（６－ｋｅｔｏ－ＰＧＦ１ａ／ＴＸＢ２）高，治疗１组较对照组比值高；治疗组与对照组血镁浓度无差异。结论：口服小剂量镁剂可有效地预防妊高征的发生，其作用机理可能为促使前列环素Ｉ２与血栓素Ａ２处于平衡状态，与血镁浓度无关。

Objective: To study the effects of oral low dose magnesium gluconate in prevention of pregnancy induced hypertension (PIH) and its mechanism. Methods: A prospective randomized double blind study was carried out in 51 pregnant women as treatment group (including 22 cases as treatment group 1 and 29 cases as treatment group 2) and 51 pregnant women as controls (including 28 cases as controls group 1 and 23 cases as control group 2). Low dose magnesium gluconate (3 g/day) or placebo was given from the 28th week of gestation to delivery consecutively. Results: 4% of the pregnant women developed PIH after magnesium gluconate treatment, which was substantially lower than that in the control group (16%) ( P <0.05). In the treatment group 2, women showed higher concentration of 6 keto prostaglandin F 1 alpha (PGF 1a ) and 6 keto /thromboxane B 2 (TXB 2) (P/T) ratio than that of the control group 2. Moreover, TXB 2 level was lower than that in the control group 2. In the treatment group 1 women showed higher ratio of P/T than that of the control group 1. There were no significant differences of serum magnesiun concentration among all groups. Conclusion: Low dose magnesium gluconate may efficiently prevent PIH in high risk women. The mechanism of action of magnesium gluconate probably involves to keep the balance of PGI 2 and TXA 2, but not associates with serum magnesium level.