复方丹参注射液联合盐酸拉贝洛尔治疗妊娠高血压综合征临床观察

Clinical observation on compound Danshen injection combined with labetalol hydrochloride in the treatment of pregnancy-induced hypertension syndrome

目的妊娠高血压综合征(pregnancy-induced hypertension syndrome,PIH)常规治疗首选硫酸镁,但毒副作用较大。本研究探讨复方丹参注射液联合盐酸拉贝洛尔治疗PIH临床效果,以期为PIH治疗提供参考。方法选取本溪钢铁集团总医院2016-03-01-2018-03-01收治的100例PIH患者为研究对象,以复方丹参注射液联合盐酸拉贝洛尔治疗的患者为观察组,以单纯盐酸拉贝洛尔治疗的患者为对照组,各50例。两组持续治疗10d为1个周期。比较两组治疗前后收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)和平均动脉压(mean arterial pressure,MAP),比较两组治疗前后炎症因子水平和妊娠结局情况。结果治疗后,观察组SBP为(114.37±7.92)mm Hg,低于对照组的(125.32±8.06)mm Hg,t=6.852,P<0.01;观察组DBP为(94.03±4.21)mm Hg,低于对照组的(99.15±4.68)mm Hg,t=5.631,P<0.01;观察组MAP为(98.17±4.19)mm Hg,低于对照组的(103.64±5.23)mm Hg,t=5.772,P<0.01;观察组IL-6为(118.19±20.55)pg/L,低于对照组的(145.62±25.16)pg/L,t=5.971,P<0.01;观察组hs-CRP为(3.57±0.87)mg/L,低于对照组的(5.01±1.42)mg/L,t=6.114,P<0.01;观察组TNF-α为(13.53±5.05)ng/L,低于对照组的(18.23±5.19)ng/L,t=4.589,P<0.01。观察组剖宫产发生率为66.00%,低于对照组的84.00%,χ2=4.320,P=0.038;观察组产后出血发生率为4.00%,低于对照组的20.00%,χ2=4.640,P=0.031;观察组新生儿胎心异常发生率为2.00%,低于对照组的16.00%,χ2=4.396,P=0.036;观察组早产发生率为6.00%,低于对照组的22.00%,χ2=4.070,P=0.044;观察组新生儿窒息发生率为2.00%,与对照组的14.00%比较,差异无统计学意义,χ2=3.397,P=0.065;观察组新生儿死亡发生率为10.00%,与对照组的14.00%比较,差异无统计学意义,χ2=0.095,P=0.758;观察组胎儿宫内感染发生率为12.00%,与对照组的22.00%比较,差异无统计学意义,χ2=1.772,P=0.183。结论复方丹参注射液联合盐酸拉贝洛尔治疗HIP可有效降低患者炎症水平及改善妊娠结局。

OBJECTIVE Magnesium sulfate is the first choice for pregnancy-induced hypertension(PIH),but its toxicity is great.Therefore,this study will explore the effects of compound Danshen injection combined with labetalol hydrochloride on the inflammatory state and maternal-infant outcomes in the treatment of PIH.METHODS 100 cases of PIH patients in our hospital from March 1,2016 to March 1,2018 were selected and divided into control group and observation group according to the medication,50 cases in each group.The two groups were treated with conventional bedridden rest,diet control and intermittent oxygen absorption,and control group was injected with labetalol hydrochloride on this basis,and observation group was combined with compound Danshen injection on the basis of control group.The two groups were treated with 10 das a course of treatment.The systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP)and levels of inflammatory factors before and after treatment were detected in the two groups,and the above indexes were given t test.The pregnancy outcomes were recorded in the two groups and compared with the chi square test.RESULTS After treatment,the SBP with(114.37±7.92)mm Hg in observation group was lower than that in control group with(125.32±8.06)mm Hg(t=6.852,P<0.01).The DBP with(94.03±4.21)mm Hg in observation group was lower than that in control group with(99.15±4.68)mm Hg(t=5.631,P<0.01).The MAP with(98.17±4.19)mm Hg in observation group was lower than that in control group with(103.64±5.23)mm Hg(t=5.772,P<0.01).The IL-6with(118.19±20.55)pg/L in observation group was lower than that in control group with(145.62±25.16)pg/L(t=5.971,P<0.01).The hs-CRP with(3.57±0.87)mg/L in observation group was lower than that in control group with(5.01±1.42)mg/L(t=6.114,P<0.01).The TNF-αwith(13.53±5.05)ng/L in observation group was lower than that in control group with(18.23±5.19)ng/L(t=4.589,P<0.01).The incidence rate of cesarean section in observation group was lower than that in control group(66.00% vs 84.00%)(χ^2=4.320,P=0.038).The incidence rate of postpartum hemorrhage in observation group was lower than that in control group(4.00%vs 20.00%)(χ^2=4.640,P=0.031).The incidence rate of fetal heart abnormalities in observation group was lower than that in control group(2.00%vs 16.00%)(χ^2=4.396,P=0.036).The incidence rate of preterm birth in observation group was lower than that in control group(6.00%vs 22.00%)(χ^2=4.070,P=0.044).The incidence rate of neonatal asphyxia in observation group was not significantly different from that in control group(2.00%vs 14.00%)(χ^2=3.397,P=0.065).The incidence rate of neonatal death in observation group was not significantly different from that in control group(10.00%vs 14.00%)(χ^2=0.095,P=0.758).The incidence rate of intrauterine infection in observation group was not significantly different from that in control group(12.00%vs 22.00%)(χ^2=1.772,P=0.183).CONCLUSION Compound Danshen injection combined with labetalol hydrochloride for PIH can effectively reduce the inflammatory level and improve the maternal-infant outcomes.