硫酸镁联合低分子肝素钠治疗重度子痫前期患者的临床疗效分析

Clinical Effect of Magnesium Sulfate Combined with Low Molecular Heparin in the Treatment of Patients with Severe Preeclampsia

目的探讨硫酸镁联用低分子肝素钠治疗重度子痫前期的疗效及其对孕妇血清炎性细胞因子[白细胞介素(IL)4、IL-6]的影响。方法将深圳市龙岗区妇幼保健院于2010年9月至2012年7月收治的重度子痫前期患者108例随机分为两组,各54例。对照组单用硫酸镁治疗,试验组用硫酸镁联合低分子肝素钠治疗,比较两组治疗前后血压变化、新生儿预后及血清IL-4、IL-6水平。结果治疗后两组患者收缩压、舒张压和平均动脉压均降低,而且试验组治疗后收缩压、舒张压和平均动脉压降低更显著,与对照组比较差异均有统计学意义(t=4.730,5.242,4.773,P<0.01);两组治疗后IL-4和IL-6水平均降低,试验组治疗后血清IL-4、IL-6水平降低更明显,与对照组治疗后比较差异均有统计学意义(t=11.846,22.830,P<0.05)。试验组Apagr评分<7分占14.81%,显著低于对照组的40.74%(19/54)(χ2=5.98,P<0.05)。结论硫酸镁、低分子肝素钠联合用于重度子痫前期治疗疗效显著,能显著降低患者血压、改善新生儿预后并一定程度上抑制患者炎性反应。

Objective To explore the effect of magnesium sulfate combined with low molecular heparin in the treatment of patients with severe preeclampsia and influence on the expression of interleukin-4 （ IL-4 ） and interleukin-6 （IL-6）. Methods From Sep. 2010 to Jul. 2012,108 patients with severe preeclampsia from Longgang Maternal and Child Health Institute were divided randomly into two groups：the control group （n = 54）, treated with magnesium sulfate only, and the test group （n = 54 ）, treated with magnesium sulfate combined with low molecular heparin. The blood pressure, prognosis of neonate and the expression of IL-4 and IL-6 were compared between the two groups. Results After treatment, systolic, diastolic,and mean arte- rial pressure were lower,but systolic, diastolic and mean arterial blood pressure in the test group decreased more significantly than the control group, there were statistically significant difference （ t = 4. 730,5. 242, 4. 773,P 〈 0. O1 ） ;after treatment, IL-4 and IL-6 levels were reduced, but serum IL-4, IL-6 levels in the test group decreased more significantly than control group, there were statistically significant difference （t = 11. 846, 22. 830, P 〈 0.05 ）. The percentage of Apagr score 〈 7 was 14.81% （8/54）in the test group, lower than 40.74% （19/54） ,of the control group （ 2 = 5.98,P 〈 0.05 ）. Conclusion Effect of magnesium sulfate com- bined with low molecular heparin in the treatment of patients with severe preeclampsia is significant, which could reduce the blood pressure,improve the prognosis of neonate and has a certain anti-inflammatory effect.