甲基多巴结合拉贝洛尔治疗重度子痫前期孕妇的临床效果

Clinical Effect of Methyldopa Combined with Labetalol in the Treatment of Severe Preeclampsia Pregnant Women

目的:探讨甲基多巴联合拉贝洛尔治疗重度子痫前期的效果及安全性。方法:选取2015年7月1日-2019年6月30日笔者所在医院治疗的重度子痫前期患者405例,按照随机数字表法将其分为对照组(203例)和观察组(202例)。两组均给予硫酸镁治疗,对照组在此基础上给予硝苯地平治疗,观察组在此基础上给予甲基多巴结合拉贝洛尔治疗。比较两组临床疗效、血压、血流动力学指标、24 h尿蛋白水平、新生儿结局及不良反应发生情况。结果:观察组治疗总有效率为96.04%,高于对照组总有效率82.76%,差异有统计学意义(χ^2=32.89,P<0.05)。治疗后两组收缩压、舒张压及24 h尿蛋白均较治疗前降低,且观察组均低于对照组,差异有统计学意义(P<0.05)。治疗后两组TPR及S/D均较治疗前降低,且观察组均低于对照组,差异有统计学意义(P<0.05)。治疗后两组CI均较治疗前升高,但两组治疗后比较差异无统计学意义(P>0.05)。治疗后观察组胎盘质量、新生儿体质量及Apgar评分均优于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:甲基多巴结合拉贝洛尔治疗重度子痫前期的临床效果较好,可降低患者血压及尿蛋白水平,改善血流动力及新生儿结局,安全性好,值得临床应用。

Objective:To investigate the effect and safety of Methyldopa combined with Labetalol in the treatment of severe preeclampsia.Method:A total of 405 patients with severe preeclampsia treated in our hospital from July 1st,2015 to June 30th,2019 were selected.They were randomly divided into the control group(203 cases)and the observation group(202 cases)according to the random number table method.Both groups were treated with Magnesium Sulfate,the control group was treated with Nifedipine on this basis,and the observation group was treated with Methyldopa combined with Labetalol on this basis.The clinical effect,blood pressure,hemodynamic indexes,24 h urine protein level and neonatal outcomes and adverse reactions were compared between the two groups.Result:The total effective rate of the observation group was 96.04%,which was higher than 82.76% of the control group,the difference was statistically significant(χ^2=32.89,P<0.05).After treatment,systolic blood pressure,diastolic blood pressure and 24 h urine protein of the two groups were all lower than those before treatment,and the observation group was lower than the control group,and the differences were statistically significant(P<0.05).After treatment,TPR and S/D of the two groups were lower than those before treatment,and the observation group was lower than the control group,the differences were statistically significant(P<0.05).After treatment,the CI of the two groups were higher than those before treatment,but there was no significant difference between the two groups after treatment(P>0.05).After treatment,placental mass,neonatal mass and Apgar score in the observation group were all better than those in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Methyldopa combined with Labetalol has a good clinical effect in the treatment of severe preeclampsia,which can reduce patients’blood pressure and urine protein levels,improve hemodynamic and neonatal outcomes.It is safe and worthy of clinical application.