硝苯地平、酚妥拉明、硫酸镁分别与拉贝洛尔组合的疗效及妊娠结局比较

Comparison study on the therapeutic effects and pregnancy outcome of nifedipine,phentolamine and magnesium sulfate combined with labetalol

目的 硝苯地平、酚妥拉明、硫酸镁分别与拉贝洛尔联合应用控制妊娠高血压综合征,追踪其各自联合后控制妊娠高血压综合征的效果,并追踪各自联合用药最后的妊娠结局,探讨控制妊娠高血压综合征的最佳药物组合。方法 选取2017年5月至2019年1月就诊的妊娠高血压综合征患者,根据入组研究对象登记序号,随机将数字表把共计117例患者分为研究组和对照组1、对照组2,每组39例。其中研究组给以硝苯地平和拉贝洛尔联合应用控制妊娠高血压综合征,而对照组1给以硫酸镁和拉贝洛尔联合应用控制妊娠高血压综合征,对照组2给以酚妥拉明和拉贝洛尔联合应用控制妊娠高血压综合征,对比研究组与对照组1和对照组2治疗过程中临床效果,并追踪各组的妊娠结局,收集各组数据进行分析对比。结果 研究组与对照组1进行比较,研究组孕期平均收缩压、舒张压、24 h尿蛋白含量均低于对照组1,差异有统计学意义(P<0.05);研究组孕期发生子痫例数、导致早产例数、孕期发生阴道出血例数均低于对照组1,差异有统计学意义(P<0.05),研究组新生儿Apagar评分、产后新生儿平均体重高于对照组1,差异有统计学意义(P<0.05);研究组发生新生儿窒息例数、产后1周血压未恢复正常的例数少于对照组1;研究组与对照组2进行比较,研究组孕期平均收缩压、舒张压、24 h尿蛋白含量均低于对照组2,差异有统计学意义(P<0.05);研究组孕期发生子痫例数、导致早产例数、孕期发生阴道出血例数均低于对照组2,差异有统计学意义(P<0.05),研究组新生儿Apagar评分、产后新生儿平均体重高于对照组2,差异有统计学意义(P<0.05);研究组发生新生儿窒息例数、产后1周血压未恢复正常的例数少于对照组2。结论 妊娠高血压综合征患者实施硝苯地平与拉贝洛尔联合应用,其控制高血压、降低尿蛋白含量等临床效果优于硫酸镁、酚妥拉明与拉贝洛尔联合应用的效果,其妊娠结局也明显优于其他二药的联合应用,说明硝苯地平联合拉贝洛尔治疗妊娠高血压综合征是值得推广的方案。

Objective To investigate the therapeutic effects of nifedipine,phentolamine and magnesium sulfate combined with labetalol on pregnancy induced hypertension (PIH),and to observe the final pregnancy outcome of each medication so as to explore the optimization medication for controlling PIH.Methods A total of 117 patients with PIH who were treated in our hospital from May 2017 to January 2019 were enrolled in the study.According to the registration number of the subjects,these patients were randomly divided into research group,control group 1 and control group 2,with 39 cases in each group. The patients in research group were treated by nifedipine combined with labetalol,and the patients in control group 1 were treated by magnesium sulfate combined with labetalol,and the patients in control group 2 were treated by phentolamine combined with labetalol.The clinical effects,pregnancy outcomes the related indexes were observed and compared among the three groups.Results The average systolic blood pressure,diastolic blood pressure and 24-hour urinary protein content in research group were significantly lower than those in control group 1 (P<0.05). The cases of eclampsia during pregnancy,premature birth and vaginal bleeding during pregnancy in research group were significantly lower than those in control group 1 (P<0.05). The Aparg scores and average weight of postpartum neonates in research group were significantly higher than those in control group 1 (P<0.05). The cases of neonatal asphyxia and blood pressure not returning to normal levels in the first week after delivery in research group were significantly less than those in control group 1.Moreover the mean systolic blood pressure,diastolic blood pressure and 24-hour urinary protein content in research group were significantly lower than those in control group 2 (P<0.05). The cases of eclampsia,premature birth and vaginal bleeding during pregnancy in research group were significantly lower than those in control group 2 (P<0.05).Inaddition the Aparg scores and average weight of the newborns after delivery in research group were significantly higher than those in control group 2 (P<0.05). The cases of neonatal asphyxia and blood pressure not returning to normal levels at one week after delivery in research group were significantly less than those in control group 2.Conclusion The therapeutic effects of combined application of nifedipine withlabetalol in controlling hypertension and reducingurinary protein content are superior to those bycombined application of magnesium sulfate,phentolamine and labetalol for the patients with pregnancy-induced hypertension,moreover the pregnancy outcome of patients is also superior to that by combined application of other two drugs,therefor, the combined application of nifedipine with labetalol is worth promoting in treatment of pregnancy-induced hypertension syndrome.