硝苯地平缓释片联合拉贝洛尔治疗妊娠期高血压临床疗效及对血清LAP、APN水平的影响

Clinical Efficacy of Nifedipine Sustained Release Tablet Combined with Labetalol on Patients with Hypertension Disorder Complicating Pregnancy and Its Effect on Serum LAP and APN Levels

目的前瞻性研究硝苯地平缓释片联合拉贝洛尔治疗妊娠期高血压临床疗效及对血清亮氨酸氨基转肽酶(leucine aminopeptidase,LAP)、脂联素(adiponectin,APN)水平的影响。方法选择2017年9月—2019年6月承德医学院附属医院收治的120例妊娠期高血压患者,采用随机数字表法分为观察组与对照组,每组60例。对照组患者给予拉贝洛尔治疗,观察组在对照组的基础上,同时口服硝苯地平缓释片,2组患者均治疗10 d。比较2组患者治疗前后收缩压和舒张压、血浆黏度和24 h尿蛋白含量的差异,统计治疗过程中不良反应的发生情况,检测治疗对妊娠结局的影响。结果2组患者经过治疗后,观察组患者的治疗总有效率为91.67%,对照组为73.33%;2组患者的血压均显著下降(P<0.05),2组比较差异具有统计学意义(P<0.05);2组患者各项指标均明显好转(P<0.05),且观察组疗效显著优于对照组(P<0.05)。对2组患者的妊娠结局进行监测,联用硝苯地平缓释片的观察组患者早产率低于对照组(P<0.05);顺产率高于对照组(P<0.05)。2组患者的药物不良反应发生率没有显著差异。结论硝苯地平缓释片和拉贝洛尔联用治疗妊娠期高血压效果良好,且治疗后,有效降低了患者体内血清高敏C-反应蛋白和同型半胱氨酸水平,减少了炎症对血管内壁的损伤,提高了LAP和APN的水平,减轻内皮功能损伤,扩张微小动脉,降低患者血压和早产的风险,改善妊娠结局,有进一步探究的意义。

OBJECTIVE To prospectively study the clinical efficacy of nifedipine sustained release tablet combined with labetalol in the treatment of patient with hypertension disorder complicating pregnancy and its effect on serum leucineaminopeptidase(LAP)and adiponectin(APN)levels.METHODS The 120 patients with hypertension disorder complicating pregnancy admitted to Affiliated Hospital of Chengde Medical College from September 2017 to June 2019 were selected and divided into observation group and control group by random number table method,with 60 cases in each group.Patients in the control group were treated with labetalol,while patients in the observation group were treated with nifedipine sustained release tablets orally on the basis of the control group for 10 d.The differences in systolic blood pressure and diastolic blood pressure,plasma viscosity and 24 h urine protein content before and after treatment were compared between the two groups.The occurrence of adverse reactions in the treatment process was counted and the effect of treatment on pregnancy outcome was detected.RESULTS After treatment,the total effective rate was 91.67%in the observation group and 73.33%in the control group.The blood pressure of the two groups decreased significantly(P<0.05),and the difference between the two groups was statistically significant(P<0.05).All the indicators of the two groups were significantly improved(P<0.05),and the efficacy of the observation group was significantly better than that of the control group(P<0.05).The pregnancy outcomes of the two groups were monitored.The rate of preterm delivery in the observation group combined with nifedipine sustained release tablets was lower than that in the control group(P<0.05).The natural birth rate was higher than the control group(P<0.05).There was no significant difference in the incidence of adverse drug reactions between the two groups.CONCLUSION Nifedipine sustained-release tablets combined with labetalol has a good effect in the treatment of hypertension disorder complicating pregnancy,and after treatment,it can effectively reduce the serum levels of high-sensitivity C-reactive protein and homocysteine,reduce the damage of inflammation on the vascular wall,and improve LAP and APN levels,it can also reduce endothelial dysfunction,dilate arterioles,reduce blood pressure and risk of premature delivery,and improve pregnancy outcomes of the patients.It has the significance of further exploration.