高压氧综合治疗对胎儿宫内发育迟缓患者的临床疗效及血浆内皮素、一氧化氮水平的影响

Effects of hyperbaric oxygen on plasma endothelin and nitric oxide in patients with intrauterine growth retardation

目的:探讨高压氧(HBO)对胎儿宫内发育迟缓(IUGR)患者的临床疗效及血浆内皮素(ET-1)、一氧化氮(NO)水平的影响。方法:选取2018年1月至2019年5月郑州大学第一附属医院妇产科接受治疗的IUGR患者90例,按照双盲抽签法分为观察组和对照组,每组45例。对照组患者给予常规性治疗,观察组在对照组的基础上联合HBO治疗。观察2组患者的临床疗效;酶联免疫吸附法检测ET-1水平,硝酸还原酶比色法检测NO水平;采用超声多普勒脐血流分析仪检测脐动脉血流收缩末期峰值与舒张值比(S/D)、阻力指数(RI)以及搏动指数(PI)值;放射免疫法测量患者血浆TXB2以及6-keto-PGF1α水平。结果:治疗3周后,观察组患者总有效率(95.56%)显著高于对照组(77.78%)( χ2=7.168, P<0.05);与治疗前比较,2组患者ET-1水平明显降低,NO水平明显提高;且观察组患者治疗后的ET-1水平显著低于对照组,NO水平高于对照组(均 P<0.05)。2组患者治疗后的脐动脉血流S/D、RI及PI值较治疗前均明显降低,且观察组患者治疗后S/D、RI及PI值显著低于对照组(均 P<0.05)。与治疗前比较,2组患者TXB2水平均明显降低,6-keto-PGF1α明显升高;且观察组患者治疗后TXB2水平明显低于对照组,6-keto-PGF1α高于对照组( P<0.05或 P<0.01)。 结论:HBO综合治疗可以明显提高IUGR患者的临床疗效,改善胎儿发育水平,值得临床推广使用。

Objective To investigate the effect of hyperbaric oxygen on plasma endothelin-1(ET-1)and nitric oxide(NO)in patients with intrauterine growth retardation(IUGR)as well as the clinical efficacy.Methods A total of 90 IUGR patients,treated in the First Affiliated Hospital of Zhengzhou University from January 2018 to May 2019,were selected and divided into the observation group and the control group according to the double-blind lottery method,with 45 patients in each group.The patients in the control group were only given routine treatment,while those in the observation group were treated with hyperbaric oxygen combined with the routine treatment as same as the control group.The therapeutic effects of the two groups were observed and recorded.The level of ET-1 was analyzed by enzyme linked immunosorbent assay,and the level of NO was tested by nitrate reductase colorimetry.The values of peak-to-diastolic ratio(S/D),resistant index(RI),and pulsation index(PI)at the end of umbilical artery vasoconstriction were detected by ultrasonic doppler umbilical cord blood flow analyzer.The levels of plasma TXB2 and 6-Keto-PGF1αwere detected by radioimmunoassay.Results After 3 weeks treatment,the total effective rate of the observation group(95.56%)was significantly higher than that of the control group(77.78%)(χ2=7.168,P<0.05);compared with those before treatment,the levels of ET-1 and NO of both groups were significantly up-regulated;the ET-1 level of the observation group after treatment was significantly lower than that of the control group,while the NO level was significantly higher(P<0.05).After treatment,the values of S/D,RI,and PI at the end of umbilical artery vasoconstriction of both the groups after treatment were all lower than those before treatment,especially the values of S/D,RI,and PI of the observation group after treatment were significantly lower than those of the control group(P<0.05).Compared with those before treatment,the levels of patients′plasma TXB2 and 6-keto-PGF1αof both the groups were significantly up-regulated;the level of patients′plasma TXB2 of the observation group after treatment was significantly lower than that of the control group,while the level of 6-keto-PGF1αwas significantly increased(P<0.05 or P<0.01).Conclusion Hyperbaric oxygen could significantly improve the clinical effect on IUGR,and improve the fetal development.This treatment,therefore,is worthy of popularization and application in clinic.