盐酸利托君与硫酸镁治疗先兆早产的效果及与Creasy高危因素评分的关系

Efficacy of Ritodrine Hydrochloride and Magnesium Sulfate in treatment of threatened preterm labor and the relationship with Creasy high-risk factor score

目的探讨盐酸利托君与硫酸镁治疗先兆早产的效果,并分析效果与Creasy高危因素评分的关系,为临床指导用药提供参考。方法将广州市番禺区何贤纪念医院2013年2月~2014年2月收治的106例诊断为先兆早产患者按单双号原则分为研究组与对照组,每组各53例。研究组采用盐酸利托君治疗,对照组患者给予硫酸镁治疗。对两组药物起效时间、延长妊娠时间、妊娠结局、新生儿一般情况和药物不良反应情况进行记录。根据两组患者保胎效果再行Creasy高危因素评分,比较两组保胎成功者Creasy≥12分的患者比率。结果治疗后研究组药物起效时间明显加快,且延长妊娠时间明显增长(P<0.05)。研究组保胎成功率显著高于对照组(96.23%比83.02%)(P<0.05)。研究组新生儿出生体重和1 min Apgar评分均优于对照组(P<0.05)。且研究组的不良反应发生率明显低于对照组(3.77%比15.09%)(P<0.05)。两组保胎成功者Creasy高危因素评分均明显低于保胎失败者(P<0.05)。研究组Creasy高危因素评分≥12分患者比率高于对照组(26.42%比15.09%)(P<0.05)。结论盐酸利托君治疗先兆早产临床效果优于硫酸镁,药物起效时间快,对于延长患者孕龄、提高新生婴儿的存活率方面效果显著,且不良反应较轻微。Creasy高危因素评分对先兆早产的妊娠结局具有重要影响,对Creasy高危评分≥12分的先兆早产患者,应优先考虑使用盐酸利托君治疗。

Objective To study the clinical curative effect of Ritodrine Hydrochloride and Magnesium Sulfate in the treatment of threatened premature labor, and to analyze relationship of effect and Creasy high-risk factor score, to provide a reference for clinical medication guide. Methods One hundred six cases of patients with threatened premature labor in Hexian Memorial Hospital of Panyu Area in Guangzhou City from February 2013 to February 2014 were divided into two groups, the study group and the control group, each of 53 cases. Study group was treated with Ritodrine Hydrochloride therapy, the control group was treated with Magnesium Sulfate therapy. The onset time for the two drugs,prolonged time to pregnancy, neonatal survival and adverse reactions were recorded. According to the effect of preventing miscarriages, then Creasy high-risk factor score was taken, the success rate of preventing miscarriages with Creasy high-risk factor score ≥ 12 points was compared. Results After treatment, the drug onset time of study group was accelerated and prolonged time for pregnancy was significantly increased, there were significant differences（P 〈0.05）. The success rate of preventing miscarriages in study group was significantly higher than that in the control group（96.23% vs 83.02%）（P 〈0.05）. The birth weight and 1 min Apgar scores in study group were better than the control group, the differences were significant（P 〈0.05）. And the incidence of adverse reactions in study group was significantly lower than the control group（3.77% vs 15.09%）, there was a significant difference（P 〈0.05）. The Creasy highrisk factor scores for patients succeeded in preventing miscarriages in both groups were significantly than those failed in preventing miscarriages（P 〈0.05）. The rate of patients with Creasy high-risk factor score ≥ 12 points in study group was significantly higher than that in control group（26.42% vs 15.09%）（P 〈0.05）. Conclusion The clinical efficacy of Ritodrine Hydrochloride in treatment of threatened preterm labor is superior to Magnesium Sulfate. The drug onset time is rapid, prolong gestation, it has significant effect for prolonging the time of gestational age, enhancing the survival rate of newborn babies, and adverse reactions are mild. Creasy high-risk factor score has an important impact on pregnancy outcome of threatened premature labor, for patients with threatened preterm labor and Creasy high-risk factor score ≥ 12 points, Ritodrine Hydrochloride should be given priority.