复方丹参注射液联合低分子肝素和硝苯地平治疗子痫前期的临床疗效研究

Clinical efficacy of cmpound Danshen injection combined with low molecular weight heparin and nifedipine in the treatment of preeclampsia

目的观察复方丹参注射液联合低分子肝素、硝苯地平对子痫前期患者人绒毛膜促性腺激素(β-h CG)、妊娠相关蛋白A(PAPP-A)、甲胎蛋白(AFP)、内源性哇巴因(EO)的表达及预后的影响。方法 130例子痫前期患者随机分为试验组及对照组,各65例。对照组皮下注射低分子肝素钠注射液5000 U,每天1次;口服硝苯地平缓释片10 mg,每天2次。试验组在对照组的基础上,加用复方丹参注射液16 mL,溶于0.9%氯化钠溶液250 mL中静脉滴注,每天1次,2组均治疗5 d。比较2组治疗前后的β-h CG、PAPP-A、AFP及EO表达变化,评价预后及妊娠结局。结果治疗后,2组患者β-h CG、AFP、EO较治疗前均显著下降,PAPP-A较治疗前显著上升(P<0.05),尿量、凝血酶原时间、活化部分凝血酶原时间均显著升高,尿蛋白、收缩压、舒张压、D-二聚体、纤维蛋白原均显著降低(P<0.05),试验组变化更显著(P<0.05)。2组终止妊娠原因差异无统计学意义(P>0.05)。试验组与对照组分娩方式差异无统计学意义(P>0.05)。试验组终止妊娠时间、新生儿体重均显著高于对照组(P<0.05)。试验组产后2 h出血量显著低于对照组(P<0.05)。结论复方丹参注射液联合低分子肝素、硝苯地平对子痫前期患者有一定的临床疗效。

Objective To observe the clinical efficacy of compound Danshen injection combined with low molecular weight heparin and nifedipinet on β human chorionic gonadotropin（β-h CG） and pregnancy associated plasma protein A（PAPP-A） and alpha fetoprotein（AFP）,endogenous ouabain（EO） and the expression of the prognosis in patients with preeclampsia. Methods A total of 130 patients with preeclampsia were randomly divided into treatment group and control group,65 cases in each group. Control group was treated with low molecular weight heparin 5000 U qd,nifedipine 10 mg bid. Treatment group was treated with compound Danshen injection 16 mL and 0. 9% NaCl 250 mL on the basis of control group. The changes of PAPP-A,AFP and β-h CG,EO of the two groups were compared before and after treatment,the prognosis and outcome of pregnancy also evaluated. Results β-h CG,AFP,EO significantly decreased in two groups after treatment,PAPP-A significantly increased（P〈0. 05）,The urine volume,activated partial thromboplastin time,prothrombin time significantly increased,urinary protein,systolic blood pressure,diastolic blood pressure,fibrinogen,D-dimer significantly decreased（P〈0. 05）,treatment group was more obvious（P〈0. 05）. The reasons of termination pregnancy in two groups had no statistical difference（P〉0. 05）. There was no significant difference in delivery mode of the two groups（P〉0. 05）. The time of termination of pregnancy and neonatal weight were significantly shorter than those in control group. The 2 h postpartum hemorrhage was significantly lower than that in control group（P〈0. 05）. Conclusion Compound Danshen injection combined with low molecular weight heparin and nifedipine had clinical effect on patients with preeclampsia.