硝酸甘油联合硫酸镁治疗妊娠高血压综合征患者的血流变控制情况及治疗效果

Control of hemorheology and the therapeutic effect of patients with pregnancy induced hypertension treated with nitroglycerin combined with magnesium sulfate

目的观察分析对妊娠高血压综合征患者采用硝酸甘油联合硫酸镁治疗后血流变的控制情况及治疗效果。方法选取珠海市妇幼保健院于2015年1月1日至2020年1月1日收治的妊娠高血压综合征患者60例,按随机双盲法将其分为联合组与对照组,每组各30例,对照组给予基础对症处理+硫酸镁治疗,联合组给予基础对症处理+硝酸甘油+硫酸镁治疗,连续治疗7 d后监测两组血流变指标[全血黏度(BV)、血浆黏度(PV)、血细胞比容(Hct)]、血压[收缩压(SBP)、舒张压(DBP)]及24 h尿蛋白定量(24 h pro)情况,评估其临床疗效并记录不良妊娠结局。结果治疗后,两组BV、PV、Hct指标与治疗前比较显著降低,联合组BV、PV、Hct指标明显低于对照组,差异有统计学意义(P<0.05);治疗后两组SBP、DBP、24 h pro指标较治疗前比较显著降低,联合组SBP、DBP、24 h pro指标明显低于对照组,差异有统计学意义(P<0.05);治疗后,联合组临床治疗总有效率为96.67%,显著高于对照组的66.67%,差异有统计学意义(P<0.05);治疗后,联合组早产、产后出血、胎儿窘迫、新生儿窒息等不良妊娠结局总发生率为9.99%,显著低于对照组的36.66%,差异有统计学意义(P<0.05)。结论针对妊娠高血压综合征患者采用硫酸甘油联合硫酸镁治疗效果显著,可有效改善血流变指标,降低血压,缓解蛋白尿症状,并减少不良妊娠结局。

Objective To observe and analyze the control of hemorheology and the therapeutic effect of patients with pregnancy induced hypertension(PIH)treated with nitroglycerin combined with magnesium sulfate.Methods A total of 60 patients with PIH from 1 January 2015 to 1 January 2020 in Zhuhai Maternal and Child Health Hospital were selected and divided into the combination group(n=30)and the control group(n=30)according to the randomized double-blind method.The control group was treated with basic symptomatic therapy+magnesium sulfate,while the combination group was treated with basic symptomatic therapy+nitroglycerin+magnesium sulfate.After 7 days of treatment,hemorheological indexes(BV,PV,Hct),blood pressure(SBP,DBP)and 24 h urine protein quantification(24 h pro)of the two groups were monitored.Clinical efficacy was assessed and adverse pregnancy outcomes were recorded and compared.Results After treatment,BV,PV and Hct indexes of the two groups were significantly lower than those before treatment,and BV,PV and Hct indexes of the combination group were significantly lower than those of the control group,with statistically significant differences(P<0.05).After treatment,SBP,DBP and 24 h pro indexes in the two groups were significantly lower than those before treatment,and SBP,DBP and 24 h pro indexes in the combination group were significantly lower than those in the control group,with statistically significant differences(P<0.05).After treatment,the total effective rate of clinical treatment in the combination group(96.67%)was significantly higher than that in the control group(66.67%),with statistically significant difference(P<0.05).After treatment,the total incidence of adverse pregnancy outcomes,such as preterm birth,postpartum hemorrhage,fetal distress and neonatal asphyxia,in the combination group(9.99%)was significantly lower than that in the control group(36.66%),and the difference was statistically significant(P<0.05).Conclusion Nitroglycerin combined with magnesium sulfate for the treatment of patients with PIH has a significant effect,which can improve hemorheological indexes,lower blood pressure,relieve symptoms of proteinuria and reduce adverse pregnancy outcomes.