拉贝洛尔联合硝苯地平缓释片治疗妊娠期高血压疾病患者的效果

Effect of Labetalol Combined with Nifedipine Sustained-release Tablets in the Treatment of Hypertensive Disorders of Pregnancy

目的:研究拉贝洛尔联合硝苯地平缓释片治疗妊娠期高血压疾病患者的效果。方法:回顾性选取2019年11月-2020年11月沭阳县中医院进行治疗的183例妊娠期高血压疾病患者。根据用药不同将其分为单药组(n=91)和联合组(n=92)。两组均给予基础治疗,单药组给予硝苯地平缓释片,联合组给予拉贝洛尔联合硝苯地平缓释片治疗。比较两组治疗前后血压水平、肾功能指标、凝血功能、血液流变学指标、氧化应激指标、内皮功能指标、临床疗效及不良母婴结局。结果:治疗后,联合组收缩压和舒张压均低于单药组(P<0.05)。治疗后,联合组24 h尿蛋白、24 h尿肌酐、过氧化脂质(lipid peroxide,LPO)水平均低于单药组,总抗氧化能力(total antioxidant capacity)水平高于单药组(P<0.05)。治疗后,两组活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶原时间(prothrombin time,PT)延长,全血高切黏度(whole blood high shear viscosity,HBV)、全血中切黏度(whole blood viscosity,WBV)、全血低切黏度(whole blood low shear viscosity,LBV)下降,联合组APTT、PT均长于单药组,HBV、WBV、LBV均低于单药组(P<0.05)。治疗后,联合组一氧化氮(nitric oxide,NO)、前列环素I2(prostacyclin I2,PGI2)水平均高于单药组,血栓素A2(thromboxane A2,TXA2)水平低于单药组(P<0.05)。联合组总有效率高于单药组(P<0.05)。联合组不良母婴结局发生率低于单药组(P<0.05)。结论:拉贝洛尔联合硝苯地平缓释片治疗妊娠期高血压疾病患者,能够降低血压水平,明显改善凝血功能、血液流变学,减轻氧化应激反应,提升肾功能、内皮功能,治疗效果显著。

Objective:To study the effect of Labetalol combined with Nifedipine Sustained-release Tablets in the treatment of hypertensive disorders of pregnancy.Method:A total of 183 patients with hypertensive disorder of pregnancy treated in Shuyang Hospital of Traditional Chinese Medicine from November 2019 to November 2020 were selected retrospectively.They were divided into single drug group(n=91)and combined group(n=92)according to the different drugs.Both groups were given basic treatment,the single drug group was given Nifedipine Sustained-release Tablets,and the combined group was given Labetalol combined with Nifedipine Sustained release Tablets.Blood pressure,renal function,coagulation function,hemorheology,oxidative stress,endothelial function before and after treatment,clinical efficacy and adverse maternal and infant outcomes were compared between the two groups.Result:After treatment,the systolic blood pressure and diastolic blood pressure in the combined group were lower than those in the single drug group(P<0.05).After treatment,the levels of 24 h urine protein,24 h urine creatinine,lipid peroxide(LPO)in the combined group were lower than those in the single drug group,and the level total antioxidant capacity(TAC)in the combined group was higher than that in the single drug group(P<0.05).After treatment,the activated partial thromboplastin time(APTT),prothrombin time(PT)in the two groups were prolonged,and the whole blood high shear viscosity(HBV),whole blood viscosity(WBV),and whole blood low shear viscosity(LBV)in the two groups declined,APTT and PT in the combined group were longer than those in the single drug group HBV,WBV and LBV were lower than those in the single drug group(P<0.05).After treatment,the levels of nitric oxide(NO)and prostacyclin I2(PGI2)in the combined group were higher than those in the single drug group,and the level of thromboxane A2(TXA2)was lower than that in the single drug group(P<0.05).The total effective rate of combined group was higher than that of single drug group(P<0.05).The incidence of adverse maternal and infant outcomes in the combined group was lower than that in the single drug group(P<0.05).Conclusion:Labetalol combined with Nifedipine Sustained-release Tablets in the treatment of hypertensive disorders of pregnancy can reduce blood pressure level,significantly improve coagulation function and hemorheology,reduce oxidative stress reaction,improve renal function and endothelial function,and the therapeutic effect is significant.