甲基多巴联合丹参注射液对妊娠期高血压疾病患者血清相关因子水平变化及母婴结局的影响

Effect of methyldopa combined with Danshen injection on changes of serum related factors and maternal and infant outcomes in patients with hypertensive disorder complicating pregnancy

目的探讨甲基多巴联合丹参注射液对妊娠期高血压疾病患者血清相关因子水平变化及母婴结局的影响。方法选取2014年11月至2017年7月青海省人民医院收治的98例妊娠期高血压疾病患者,根据随机数字表法分为观察组和对照组,每组49例。两组入院后均给予常规治疗及硫酸镁注射液解痉、镇静,在此基础上,对照组给予甲基多巴治疗,观察组给予甲基多巴+丹参注射液治疗。对比两组治疗前后血压[收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)]控制情况、血清相关因子[前列腺素E_2(prostaglandin E_2,PGE_2)、胃饥饿素(ghrelin)、内皮素-1(endothelin 1,ET-1)]水平、分娩方式及不良妊娠结局发生率,统计两组治疗期间不良反应发生率。结果 (1)血压控制:两组SBP、DBP水平治疗前比较差异无统计学意义(P>0.05),治疗后均明显改善(P<0.05),且观察组SBP、DBP水平低于对照组(P<0.05)。(2)血清相关因子:两组血清PGE_2、Ghrelin、ET-1水平治疗前比较差异无统计学意义(P>0.05),治疗后均明显改善(P<0.05),且观察组血清ET-1水平低于对照组,PGE_2、Ghrelin水平高于对照组(P<0.05)。(3)分娩方式及母婴结局:观察组阴道分娩率(63.27%)高于对照组(42.86%)(P<0.05);早产、胎儿窘迫发生率(16.33%、10.20%)均低于对照组(34.69%、26.53%)(P<0.05);两组产后出血、新生儿窒息发生率比较差异无统计学意义(P>0.05)。(4)安全性:两组不良反应发生率比较差异无统计学意义(P>0.05)。结论甲基多巴联合丹参注射液治疗妊娠期高血压疾病,血压控制效果较佳,可有效改善患者血清PGE_2、Ghrelin、ET-1水平,降低不良妊娠结局发生率,且具有一定安全性。

Objective To investigate the effect of methyldopa combined with Danshen injection on changes of serum related factor levels and maternal and infant outcomes in patients with hypertensive disorder complicating pregnancy（ HDCP）. Methods A total of 98 patients with HDCP from November 2014 to July 2017 in Qinghai Provincial People＇s Hospital were selected and divided into the observation group and the control group according to random number table,with 49 cases in each group. Both groups were given routine treatment and magnesium sulfate injection for spasmolysis and sedation after admission. On this basis,the control group was given methyldopa treatment,and the observation group was given Danshen injection and methyldopa. The blood pressure control condition[systolic blood pressure（ SBP）,diastolic blood pressure（ DBP） ],serum related factors levels [prostaglandin E2（ PGE2）,ghrelin（ Ghrelin）,endothelin-1（ ET-1） ],mode of delivery and incidence of adverse pregnancy outcomes were compared between the two groups before and after treatment. The incidence of adverse reactions in the two groups during treatment was counted. Results （1） Blood pressure control ： there were no significant differences in the levels of SBP and DBP between the two groups before treatment（ P〈0. 05）. After treatment,both group were improved（ P〈0. 05）,and the levels of SBP and DBP in the observation group were lower than those in the control group（ P〈0. 05）.（2） Serum related factors： there were no significant differences in serum PGE2,Ghrelin and ET-1 levels between the two groups before treatment（ P〈0. 05）. After treatment,all of them in the two groups were improved（ P〈0. 05）,and the level of serum ET-1 in the observation group was lower than that in the control group,and the levels of PGE2 and Ghrelin were higher than those of the control group（ P〈0. 05）.（3） The mode of delivery and maternal fetal outcomes： the vaginal delivery rate of the observation group（ 63. 27 %） was higher than that in the control group（ 42. 86 %）（ P〈0. 05）; the incidence of preterm birth and fetal distress（ 16. 33 %,10. 20 %） were lower than those in the control group（ 34. 69 %,26. 53 %）（ P〈0. 05）. There were no significant differences in the incidence of postpartum hemorrhage and neonatal asphyxia between the two groups（ P〈0. 05）.（4） Safety： there were no significant difference in the incidence of adverse reactions between two groups（ P〈0. 05）.Conclusion Methyldopa combined with Danshen injection in the treatment of patients with HDCP,has good blood pressure control effect. It can effectively improve the serum levels of PGE2,Ghrelin and ET-1,reduce the incidence of adverse pregnancy outcomes,and has certain safety.