利托君辅助治疗对胎膜早破患者宫缩抑制的影响

Effect of ritodrine adjuvant therapy on suppressing uterine contraction of patients with preterm premature rupture of membranes

目的分析应用利托君辅助治疗对早产胎膜早破患者宫缩抑制、血核因子-κB P65(NF-κB P65)和髓系细胞触发受体(TREM-1)的影响及安全性。方法随机选取在四川省成都市西区医院自2016年1月至2017年9月就诊的早产胎膜早破患者共70例,设计双盲试验,根据随机列表法将全部患者进行分组,包含对照组(35例)与试验组(35例)。综合评估产妇的胎位和胎儿体征等状况,对照组的患者在抗B族链球菌(GBS)类抗生素的基础上应用硫酸镁进行辅助治疗,试验组的患者在抗GBS类抗生素的基础上应用硫酸镁和利托君辅助治疗。记录并比较两组患者的疗效、宫缩抑制时间、不良反应比例、血NF-κB P65和TREM-1水平。结果试验组患者的治疗总有效率显著高于对照组(χ2=4.629,P<0.05),试验组患者的宫缩抑制时间均显著低于对照组(t=13.504,P<0.05),治疗后,两组患者的血NF-κB P65和TREM-1水平均比治疗前显著降低(t值分别为5.677、8.691、4.004、4.266,均P<0.05),但治疗后试验组患者的血NF-κB P65和TREM-1水平均较对照组显著降低(t值分别为5.512、7.687,均P<0.05),两组患者的总不良反应发生率无显著性差异(χ2=0.971,P>0.05)。结论利托君能有效提高早产胎膜早破患者的临床疗效,缩短患者的宫缩抑制时间,降低患者的炎症反应。

Objective To analyze the effect of ritodrine adjuvant therapy on suppressing uterine contraction,nucler transcription factor-κB P65（NF-κB P65）and triggering receptor expressed mycloid cells-1（TREM-1）of patients with preterm premature rupture of membranes and its safety.Methods A total of 70 patients with preterm premature rupture of membranes in Chengdu West District Hospital from January 2016 to September 2017 were randomly selected.The double-blind trial was designed.All patients were divided into control group（35 cases）and experimental group（35 cases）according to shuffled list.The fetal position and fetal signs were comprehensively assessed.The patients in the control group took Magnesium Sulfate adjuvant therapy based on anti-GBS antibiotics,and those in the experimental group took Magnesium Sulfate and ritodrine adjuvant therapy based on antiGBS antibiotics.The efficacy,uterine inhibition time,proportion of adverse reactions,blood NF-κB P65 and the TREM-1 levels of two groups were recorded and compared.Results The total treatment effective rate in the experimental group was significantly higher than that in the control group（χ^2=4.629,P〈0.05）.The uterine inhibition time in the experimental group was shorter than that in the control group（t=13.504,P〈0.05）.Blood NF-κB P65 and TREM-1 levels in two group after treatment were significantly lower than those before treatment（t value was 5.677,8.691,4.004 and 4.266,respectively,all P〈0.05）.After treatment,NF-κB P65 and TREM-1 levels in the experimental group were significantly lower than those in the control group（t value was 15.512 and 7.687,respectively,both P〈0.05）.The proportion of adverse reactions between two groups had no significant difference（χ^2=0.971,P〉0.05）.Conclusion Ritodrine can effectively improve the clinical efficacy in patients with preterm premature rupture of membranes,shorten uterine inhibition time,and reduce inflammatory reaction.