维生素E联合拉贝洛尔对妊娠期高血压患者血清S100-B蛋白、hs-CRP和PAPP-A水平的影响

Effect of Vitamin E combined with Normodyne on serum S100-B protein,hs-CRP and PAPP-A levels in patients with hypertension during pregnancy

目的研究维生素E联合拉贝洛尔对妊娠期高血压患者血清S100-B蛋白、高敏C反应蛋白(hs-CRP)和妊娠相关血清蛋白A(PAPP-A)水平的影响。方法回顾性选取2017年1月至2020年12月亳州市人民医院门诊收治的120例妊娠期高血压患者作为研究对象,用抽签法随机将其分为2组:对照组和观察组,每组各60例。对照组单用拉贝洛尔(100 mg/次,3次/d)治疗,观察组采用维生素E(100 mg/次,2次/d)联合拉贝洛尔治疗,均连续治疗1个月。观察2组患者的临床疗效,检测2组治疗前、治疗1个月后的收缩压、舒张压、尿蛋白水平、凝血酶原时间(PT)、纤维蛋白原(FIB)以及活化部分凝血酶原时间(APTT);酶联免疫吸附试验检测血清S100-B蛋白、hs-CRP和PAPP-A水平。结果观察组患者的治疗总有效率(95.00%)明显高于对照组(68.33%),差异有统计学意义(P<0.05)。治疗前,2组患者收缩压、舒张压和尿蛋白、PT、FIB、APTT、血清S100-B蛋白、hs-CRP和PAPP-A水平比较,差异均无统计学意义(P>0.05);治疗1个月后,观察组患者收缩压、舒张压、尿蛋白分别为(117.69±10.57)mmHg、(83.67±10.15)mmHg、(2.26±0.29)g/24 h均较对照组[(124.78±11.46)mmHg、(91.67±14.28)mmHg、(2.35±0.37)g/24 h]显著降低,差异均有统计学意义(P<0.05);观察组患者FIB为(2.45±0.13)g/L,较对照组[(3.29±0.42)g/L]显著降低,PT和APTT分别为(13.67±3.59)s、(28.72±4.39)s,较对照组[(11.45±2.63)s、(25.63±2.48)s]明显延长,差异均有统计学意义(P<0.05);观察组患者血清S100-B蛋白、hs-CRP和PAPP-A水平分别为(0.35±0.09)μg/L、(1.53±0.14)mg/dL、(8.72±1.31)mIU/L,较对照组[(0.67±0.14)μg/L、(1.82±0.27)mg/dL、(12.53±1.46)mIU/L]显著降低,差异均有统计学意义(P<0.05)。妊娠期高血压治疗效果与血清S100-B蛋白、hs-CRP和PAPP-A水平均呈显著负相关(r=-0.543、-0.508、-0.602,P<0.05)。结论维生素E联合拉贝洛尔对妊娠期高血压有显著的疗效,其机制可能与降低血清S100-B蛋白、hs-CRP和PAPP-A水平有关。

Objective To study the effect of vitamin E combined with normodyne on serum human S100B protein,high sensitivity C-reactive protein(hs-CRP)and pregnancy-associated serum protein A(PAPP-A)levels in patients with hypertension during pregnancy.Methods A total of 120 patients with hypertension during pregnancy admitted to Department of Outpatient,Bozhou People's Hospital from January 2017 to December 2020 were retrospectively selected as the research object.They were randomly divided into 2 groups by lottery,control group and observation group,with 60 cases in each group.The control group was treated with labetalol alone(100 mg/time,3 times/d),and the observation group was treated with vitamin E(100 mg/time,2 times/d)in combination with labetalol,1 month of continuous treatment.The treatment effect of the two groups was observed,and the systolic blood pressure,diastolic blood pressure,urine protein level,prothrombin time(PT),fibrinogen(FIB)and activated partial prothrombin time(APTT)of the two groups before and after 1 month of treatment were detected;Serum S100-B protein,hs-CRP and PAPP-A levels were detected by enzyme-linked immunosorbent assay.Results The total effective rate of treatment in the observation group(95.00%)was significantly higher than that of the control group(68.33%),and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in the levels of systolic blood pressure,diastolic blood pressure and urine protein,PT,FIB,APTT,serum S100-B protein,hs-CRP and PAPP-A between the two groups(P>0.05).After 1 month of treatment,the systolic blood pressure,diastolic blood pressure and urine protein in the observation group were(117.69±10.57)mmHg,(83.67±10.15)mmHg,and(2.26±0.29)g/24 h,respectively,which were significantly lower than those in the control group[(124.78±11.46)mmHg,(91.67±14.28)mmHg,(2.35±0.37)g/24 h],and the differences were statistically significant(P<0.05);FIB in the observation group was(2.45±0.13)g/L,which was lower than that in the control group[(3.29±0.42)g/L],PT and APTT were(13.67±3.59)s and(28.72±4.39)s,respectively,which were significantly longer than those in the control group[(11.45±2.63)s,(25.63±2.48)s],the differences were statistically significant(P<0.05);the levels of serum S100-B protein,hs-CRP and PAPP-A in the observation group were(0.35±0.09)μg/L,(1.53±0.14)mg/dL,(8.72±1.31)mIU/L,respectively,which were significantly lower than those in the control group[(0.67±0.14)μg/L,(1.82±0.27)mg/dL,(12.53±1.46)mIU/L],and the differences were statistically significant(P<0.05).The therapeutic effect of hypertension during pregnancy was significantly negatively correlated with serum S100-B protein,hs-CRP and PAPP-A levels(r=-0.543,-0.508,-0.602,P<0.05).Conclusion Vitamin E combined with normodyne has a significant effect on hypertension during pregnancy,and its mechanism may be related to the reduction of serum S100-B protein,hs-CRP and PAPP-A levels.