硝苯地平联合硫酸镁治疗妊娠期高血压患者的临床研究

Clinical trial of nifedipine combined with magnesium sulfate in the treatment of patients with hypertension during pregnancy

目的观察硝苯地平联合硫酸镁对妊娠期高血压患者血流动力学及血浆内皮素-1(ET-1)、一氧化氮(NO)水平的影响。方法将妊娠期高血压患者76例,随机分为对照组和试验组,各38例。对照组患者给予硫酸镁注射液,静脉滴注;试验组在对照组基础上给予硝苯地平控释片30 mg,每天1次。2组均连续治疗7 d。比较2组的临床总有效率;比较2组患者治疗前后全血高切黏度(HBV)、低切黏度(LBV)、血浆黏度(PV)、纤维蛋白原(FIB)及治疗前后血浆ET-1、NO水平;比较2组患者治疗期间的药物不良反应发生情况。结果治疗后,对照组与试验组的临床总有效率分别为73.68%,92.11%,差异有统计学意义(P<0.05)。治疗后,对照组与试验组HBV水平分别为(5.37±0.75),(4.16±0.78)mPa·s;LBV水平分别为(10.02±1.03),(8.64±1.21)mPa·s;PV水平分别为(1.62±0.31),(1.30±0.26)mPa·s;FIB水平分别为(3.73±0.52),(3.06±0.22)g·L^-1;血浆ET-1水平分别为(27.86±5.57),(23.37±4.51)ng·mL^-1;血浆NO水平分别为(4.65±0.76),(5.92±0.83)μmol·L^-1,差异均有统计学意义(均P<0.05)。对照组的药物不良反应发生率为13.16%,试验组为18.42%,差异无统计学意义(P>0.05)。结论硝苯地平联合硫酸镁治疗妊娠期高血压可提高治疗有效率,改善患者的血流动力学,同时调节患者血浆ET-1、NO水平,改善血管内皮细胞功能,且安全有效。

Objective To investigate the effects of nifedipine combined with magnesium sulfate on hemodynamics and plasma endothelin-1(ET-1)and nitric oxide(NO)levels in patients with hypertension during pregnancy.Methods A total of 76 patients with hypertension during pregnancy were randomly divided into control group and treatment group,with 38 cases in each group.Patients in control group were given magnesium sulfate injection,intravenous infusion;treatment group was given nifedipine controlled-release tablets 30 mg·times-1,once a day on the basis of control group.Both groups were treated continuously for 7 d.The total clinical efficacy was compared between the two groups;the high blood viscosity(HBV),low blood viscosity(LBV),plasma viscosity(PV),fibrinogen(FIB),plasma ET-1,NO levels were compared of the two groups before and after treatment.The adverse drug reactions of the two groups were compared during the treatment.Results After treatment,the total clinical effective rates of control group and treatment group were 73.68%and 92.11%,with significant difference(P<0.05).After treatment,the HBV levels in control group and treatment group were(5.37±0.75)and(4.16±0.78)mPa·s;the LBV levels were(10.02±1.03)and(8.64±1.21)mPa·s;the PV levels were(1.62±0.31)and(1.30±0.26)mPa·s;FIB levels were(3.73±0.52),(3.06±0.22)g·L^-1;the levels of ET-1 in plasma were(27.86±5.57),(23.37±4.51)ng·mL-1;the plasma NO levels were(4.65±0.76),(5.92±0.83)μmol·L^-1,all with significant difference(all P<0.05).The incidence of adverse drug reactions in control group and treatment group were 13.16%,18.42%,with no significant difference(P>0.05).Conclusion Nifedipine combined with magnesium sulfate in the treatment of hypertension during pregnancy can improve the clincal efficiency,improve the hemodynamics of patients,regulate the plasma ET-1 and NO levels,and improve the function of vascular endothelial cells,with safe and effective.