硫酸镁联合硝苯地平对妊高症患者血液流变性及妊娠结局的影响

Effect of magnesium sulfate combined with nifedipine on hemorheology and pregnancy outcomes in patients with pregnancy-induced hypertension syndrome

目的探究硫酸镁联合硝苯地平对妊娠高血压综合征（PIH）患者24h尿蛋白定量、红细胞聚集指数变化及妊娠结局的影响。方法选取本院2014年8月至2016年7月接收的75例PIH患者，依据治疗方案分为两组。单一组37例予以硫酸镁治疗，联合组38例予以硫酸镁＋硝苯地平治疗。分娩后，统计两组治疗效果及妊娠结局，并对比治疗前后血压（收缩压、舒张压）及实验室指标（24h尿蛋白定量、血浆黏度、红细胞聚集指数及红细胞比容）水平。结果联合组治疗总有效率为92．11％（35／38），明显高于单一组的70．27％（26／37），差异有统计学意义（P〈O．05）；两组治疗前收缩压、舒张压水平比较差异均无统计学意义（均P〉0．05）；治疗后，联合组收缩压、舒张压水平均低于单一组，差异均有统计学j蕞义（均P〈0．05）；两组治疗前实验室指标水平比较差异均无统计学意义（均P〉0．05）；治疗后，联合组24h尿蛋白定量、血浆黏度、红细胞聚集指数及红细胞比容均低于单一组，差异均有统计学意义（均P〈0．05）；两组胎盘早剥、新生儿窒息发生率比较差异均元统计学意义（均P〉O．05）；联合组早产、胎儿窘迫、产后出血、剖宫产率均低于单一组，差异均有统计学意义（均P〈0．05）。结论对PIH患者予以硝苯地平与硫酸镁联合治疗，可有效控制血压，降低24h尿蛋白定量、红细胞聚集指数，改善妊娠结局，效果较为显著。

Objective To investigate the effect of magnesium sulfate combined with nifedipine on 24 h urinary protein quantification, erythrocyte aggregation index, and pregnancy outcomes in patients with pregnancy induced hypertension syndrome （PIH）. Methods From August 2014 to July 2016, 75 patients with PIH in our hospital were selected and divided into single group （n=37） and combined group （n=38） according to the treatment regimen. The single group was treated with magnesium sulfate, and the combined group was treated with magnesium sulfate ＋ nifedipine. After delivery, therapeutic effect and pregnancy outcomes were statistically analyzed between the two groups, and blood pressure （systolic blood pressure, diastolic blood pressure） and laboratory indicators （24 h urinary protein quantification, plasma viscosity, erythrocyte aggregation index, and hematocrit） levels were compared between the two groups before and after treatment. Results The total effective rate in the combined group [92.11% （35/38）] was significantly higher than that in the single group [70.27% （26/37）] （P〈0.05）. There were no statistically significant differences in systolic and diastolic blood pressure between the two groups before treatment （P〉0.05）; after treatment, the systolic and diastolic blood pressure levels in the combined group were lower than those in the single group, with statistically significant differences （P〈0.05）. There were no statistically significant differences in the laboratory indexes levels between the two groups before treatment （P〉0.05）; after treatment, the 24 h urinary protein quantification, plasma viscosity, erythrocyte aggregation index, and hematocrit in the combined group were lower than those in the single group, with statistically significant differences （P〈0.05）. There were no statistically significant differences in the rates of placental abruption and neonatal asphyxia between the two groups （P〉0.05）; the rates of premature delivery, fetal distress, postpartum hemorrhage, and cesarean section in the combined group were lower than those in the single group, with statistically significant differences （P〈0.05）. Conclusion Magnesium sulfate combined with nifedipine in the treatment of PIH can effectively control blood pressure, reduce 24h urine protein quantification and erythrocyte aggregation index, improve the pregnancy outcomes, with more significant effect.