硝苯地平缓释片联合拉贝洛尔对妊娠期高血压患者血清IGF-1、sFIt-1水平及血管内皮功能的影响

Influence of nifedipine sustained-release tablets combined with labetalol on serum IGF-1 and sFIt-1 levels and vascular endothelial function in patients with hypertensive disorder complicating pregnancy

目的:探究硝苯地平缓释片联合拉贝洛尔对妊娠期高血压(HDCP)患者血清胰岛素样生长因子-1(IGF-1)、人可溶性血管内皮生长因子受体1(sFIt-1)及血管内皮功能的影响。方法:将105例HDCP患者按不同治疗方案分为对照组(n=51)和实验组(n=54)。对照组接受拉贝洛尔治疗,实验组采用拉贝洛尔和硝苯地平联合治疗,两组患者均治疗两周。使用ELISA法检测血清IGF-1、sFIt-1、内皮素-1(ET-1)水平,微量一氧化氮(NO)检测仪检测NO。比较两组患者临床疗效,血清IGF-1、sFIt-1、NO、ET-1水平,母婴结局和不良反应。结果:治疗后,实验组患者总有效率(94.44%)高于对照组有效率(80.39%)(P<0.05);两组患者血清IGF-1、sFIt-1、NO水平均升高,ET-1水平均降低;实验组血清IGF-1、sFIt-1、NO水平均高于对照组(P<0.05),ET-1水平低于对照组(P<0.05)。实验组顺产率高于对照组(P<0.05),早产率低于对照组(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:硝苯地平缓释片联合拉贝洛尔治疗HDCP疗效优于单独使用拉贝洛尔,联合用药可以升高患者血清IGF-1、sFIt-1、NO水平,降低ET-1水平,改善妊娠结局,安全性良好。

Objective:To investigate the influence of nifedipine sustained-release tablets combined with labetalol on serum insulin-like growth factor-1(IGF-1) and human soluble vascular endothelial growth factor receptor 1(sFIt-1) levels, and vascular endothelial function in patients with hypertensive disorder complicating pregnancy(HDCP).Methods:105 patients with HDCP were divided into control group(51 patients treated with labetalol) and experience group(54 patients treated with labetalol combined with nifedipine) according to the treatment methods.Both groups were treated for two weeks.Serum IGF-1,sFIt-1 and endothelin-1(ET-1) were detected by ELISA,and nitric oxide(NO) was detected by micro NO detector.The two groups were compared in terms of clinical effect, serum IGF-1,sFIt-1,NO,ET-1,maternal and neonatal outcomes, and adverse reactions.Results:The total clinical response rate in the experience group(94.44%) was higher than that in the control group(80.39%,P<0.05).After treatment, IGF-1,sFIt-1 and NO were increased, and ET-1 was decreased in the two groups.IGF-1,sFIt-1 and NO in the experience group were higher than those in the control group(P<0.05),and ET-1 was lower than that in the control group(P<0.05).The vaginal delivery rate in the experience group was higher than that in the control group(P<0.05),and the premature delivery rate was lower than that in the control group(P<0.05).There was no statistically significant difference in adverse reactions between the two groups(P>0.05).Conclusion:Nifedipine sustained-release tablets combined with labetalol in the treatment of HDCP is better than that of labetalol alone, which can increase the levels of IGF-1,sFIt-1 and NO,lower the level of ET-1,regulate vascular endothelial function, and improve maternal and neonatal outcomes, with good safety.