川芎嗪联合苯磺酸左旋氨氯地平对妊娠高血压疾病患者BNP、Ang Ⅱ及妊娠结局的影响

Effect of Ligustrazine combined with levamlodipine besylate on BNP, Ang Ⅱ and pregnancy outcomes in patients with hypertensive disorders complicating pregnancy

目的探讨川芎嗪联合苯磺酸左旋氨氯地平对妊娠高血压疾病患者血浆脑利钠肽(BNP)、血管紧张素Ⅱ(AngⅡ)及妊娠结局的影响。方法选择2016年1月~2018年1月武威市人民医院住院分娩妊娠高血压疾病患者87例,按是否使用川芎嗪分为观察组(44例)和对照组(43例),对照组在合理膳食、镇静等对症治疗基础上给予25%硫酸镁、苯磺酸左旋氨氯地平治疗,观察组在对照组基础上联合川芎嗪治疗。观察两组治疗前后BPN、AngⅡ、平均动脉压、24 h尿蛋白水平及子宫动脉、脐动脉收缩期最大血流速度与舒张末期血流速度比值(S/D)、脉搏指数(PI)及阻力指数(RI),同时观察治疗期间不良反应,治疗10 d后评定治疗效果。随访至分娩,观察两组妊娠结局。结果治疗后,观察组BNP、AngⅡ水平均低于治疗前及对照组,差异有统计学意义(P<0.05);观察组子宫动脉和脐动脉S/D、PI、RI均低于治疗前及对照组,差异有统计学意义(P<0.05)。观察组总有效率高于对照组,差异有统计学意义(P<0.05),观察组早产、剖宫产、产时或产后出血、胎盘早剥、宫内窘迫及新生儿窒息发生率均低于对照组,差异有统计学意义(P<0.05)。两组治疗期间均未见不良反应发生。结论川芎嗪注射液联合苯磺酸左旋氨氯地平治疗妊娠高血压疾病疗效满意,降低BNP、AngⅡ表达,增加子宫及胎盘供血,降低妊娠不良结局,值得临床推广。

Objective To investigate the effects of Ligustrazine combined with levamlodipine besylate on plasma brain natriuretic peptide(BNP),angiotensinⅡ(AngⅡ)and pregnancy outcome in patients with pregnancy-induced hypertension.Methods From January 2016 to January 2018,in Wuwei People′s Hospital,87 patients with pregnancy-induced hypertension were selected,they were divided into two groups according to whether they used Ligustrazine or not.The control group was given 25%magnesium sulfate and levamlodipine besylate based on symptomatic treatment such as reasonable diet and sedation.The observation group was treated with Ligustrazine on the basis of the control group.BPN,AngⅡ,mean arterial pressure,24 h urinary protein level,uterine artery,and umbilical artery systolic period the ratio of maximum blood flow velocity to end-diastolic blood flow velocity(S/D),pulse index(PI),and resistance index(RI)before and after treatment were observed,adverse reactions during treatment,treatment effect after treatment 10 d were observed.Follow-up to delivery,the pregnancy outcomes of two groups were observe.Results After treatment,the levels of BNP and AngⅡin the observation group were lower than before treatment and the control group,the differences were statistically significant(P<0.05).After treatment,the S/D,PI and RI of the uterine artery and umbilical artery in the observation group were lower than before treatment and the control group,the differences were statistically significant(P<0.05).The total effective rate in the observation group was higher than the control group,the difference was statistically significant(P<0.05).The incidence rates of premature labor,cesarean section,intrapartum or postpartum hemorrhage,placental abruption,intrauterine distress and neonatal asphyxia in the observation group were lower than the control group,the differences were statistically significant(P<0.05).No adverse reactions occurred in both groups during treatment.Conclusion Ligustrazine injection combined with levamlodipine besylate has a satisfactory therapeutic effect on gestational hypertension,reducing the expression of BNP and AngⅡ,increasing uterine and placental blood supply,and reducing the adverse outcomes of pregnancy.It is worthy of clinical promotion.