拉贝洛尔与甲基多巴联合用药对妊娠高血压孕妇生化与血液动力学指标的影响

Study on the Effect of Combination of Labetalol and Methyldopa on Maternal Biochemical Indicators and Hemodynamic Parameters in Pregnancy-induced Hypertension

目的:评价拉贝洛尔与甲基多巴联合用药对妊娠高血压孕妇血管内皮生长因子(vascular endothelial growth factor, VEGF)、妊娠相关血浆蛋白A(pregnancy-associated plasma protein, PAPPA)及相关血液动力学指标的影响。方法:纳入2017年11月至2018年10月在我院治疗的156例妊娠期高血压患者,根据随机数字表法划分为治疗组(n=78)与对照组(n=78)。对照组患者应用硫酸镁注射液治疗,治疗组患者应用盐酸拉贝洛尔注射液联合甲基多巴片治疗。记录并比较治疗前后2组患者24h尿蛋白、心脏指数及外周阻力、平均动脉压、脐血流、VEGF及PAPPA指标,记录患者发生不良反应情况。结果:治疗后,两组患者平均动脉压、24h尿蛋白、脐血流、心脏指数、外周阻力、VEGF与PAPPA指标均比治疗前显著改善(均P<0.05)。治疗后,治疗组患者平均动脉压、心脏指数、外周阻力与PAPPA均比对照组显著改善(P<0.05)。治疗组与对照组患者不良反应发生率比较没有统计学意义(42.3%vs. 44.9%,χ^2=0.140,P=0.747)。结论:拉贝洛尔与甲基多巴联用治疗妊娠高血压患者,疗效好、不良反应少、安全性高,可以明显改善妊娠高血压产妇的临床预后。

Objective:To evaluate the effects of combination of labetalol and methyldopa on vascular endothelial growth factor(VEGF),pregnancyassociated plasma protein A(PAPPA)and related hemodynamics.Methods:Atotal of 156 patients with gestational hypertension who were treated in our hospital from November 2017 to October 2018 were enrolled.According to the random number table method,thepatientsdivided into the treatment group(n=78)and the control group(n=78).Patients in the control group were treated with magnesium sulfate injection,and patients in the treatment group were treated with labetalol hydrochloride injection combined with methyldopa tablets.The 24 h urine protein,cardiac index and peripheral resistance,mean arterial pressure,umbilical blood flow,VEGF and PAPPA were recorded and compared between the two groups before and after treatment.And record the patient’s adverse reactions.Results:After treatment,the mean arterial pressure,24 h urinary protein,umbilical blood flow,cardiac index,peripheral resistance,VEGF and PAPPA were significantly improved in both groups(all P<0.05).After treatment,mean arterial pressure,cardiac index,peripheral resistance and PAPPA were significantly improved in the treatment group compared with the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the treatment group and the control group(42.3%vs 44.9%,χ^2=0.140,P=0.747).Conclusion:Labetalol combined with methyldopa in the treatment of patients with pregnancy-induced hypertension has good curative effect,less adverse reactions and high safety,which can significantly improve the clinical prognosis of pregnant women with pregnancy-induced hypertension.