硫酸镁注射液联合拉贝洛尔注射液和尼莫地平片治疗妊娠高血压的临床研究

Clinical trial of magnesium sulfate injection combined with labetalol injection and nimodipine tablets in the treatment of pregnancy-induced hypertension

目的观察硫酸镁注射液联合拉贝洛尔注射液和尼莫地平片治疗妊娠高血压(PIH)的临床疗效及安全性。方法将74例PIH患者随机分为对照组37例和试验组37例。对照组予以25%硫酸镁注射液每次20 m L,bid,静脉滴注+拉贝洛尔注射液每次50 mg,qd,静脉滴注;试验组在对照组治疗的基础上,予以尼莫地平片每次30 mg,qd,口服。2组患者均治疗7 d。比较2组患者的临床疗效、血清胱抑素C(Cys-C)的水平、妊娠结局,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为94.59%(35例/37例)和86.49%(32例/37例),差异有统计学意义(P<0.05)。治疗后,试验组和对照组的血清Cys-C水平分别为(0.87±0.10)和(1.03±0.13)mg·L^(-1),剖宫产率分别为24.32%(9例/37例)和54.05%(20例/37例),早产发生率分别为5.41%(2例/37例)和21.62%(8例/37例),差异均有统计学意义(均P<0.05)。2组患者的药物不良反应以头晕、低血压和肠胃不适为主,试验组和对照组的总药物不良反应发生率分别为13.51%和16.22%,差异无统计学意义(P>0.05)。结论硫酸镁注射液联合拉贝洛尔注射液和尼莫地平片治疗PIH的临床疗效显著,对妊娠结局有积极意义,其可能与调控Cys-C有关,且不增加药物不良反应的发生率。

Objective To observe the clinical efficacy and safety of magnesium sulfate injection combined with labetalol injection and nimodipine tablets in the treatment of pregnancy-induced hypertension（ PIH）. Methods A total of 74 patients with PIH were randomly divided into control and treatment groups with 37 cases per group. Control group received 25% magnesium sulfate injection 20 m L each time,bid,intravenous drip ＋ labetalol injection 50 mg each time,qd,intravenous drip; on the basis of the treatment of control group,the treatment group received nimodipine tablets 30 mg each time,qd,orally. All patients were treated for 7 days. The clinical effect,changes of serum levels of cystatin C（ Cys-C）,blood pressure indexes,placental hemodynamic parameters,the pregnancy outcomes,and the occurrence of adverse drug reactions were compared between two groups. Results After treatment,the total effective rates of treatment and control groups were 94. 59%（ 35 cases/37 cases） and 86. 49%（ 32 cases/77 cases） with significantdifference（ P〈0. 05）. After treatment,the main indexes in treatment and control groups were compared： the serum levels of Cys-C were（ 0. 87 ± 0. 10） and（ 1. 03 ± 0. 13） mg·L-（-1）,cesarean section rates were 24. 32%（ 9 cases/37 cases） and 54. 05%（ 20 cases/37 cases）,premature birth rates were 5. 41%（ 2 cases/37 cases） and 21. 62%（ 8 cases/37 cases）,the differences were statistically significant（ all P〈0. 05）. The adverse drug reactions of two groups were dizziness,hypotension and gastrointestinal discomfort,and the total incidence of adverse reactions of treatment group and control group were 13. 51% and 16. 22% without significant difference（ P〈0. 05）. Conclusion Magnesium sulfate injection combined with labetalol injection and nimodipine tablets has a definitive clinical efficacy in the treatment of PIH,and also has positive significance for pregnancy outcome,which may be related to the regulation of Cys-C,without increasing the incidence of adverse drug reactions.