硝苯地平联合硫酸镁治疗妊娠期高血压及母婴结局

Effects of nifedipine combined with magnesium sulfate on maternal and neonatal outcomes in hypertensive disorders of pregnancy

目的 探讨用硝苯地平硫酸镁治疗妊娠期高血压(hypertensive disor-ders of pregnancy, HDP)对氧化应激、微环境炎症及母婴结局的影响。方法 选取102例HDP患者,采用简单随机分组将患者分为观察组(n=51)和对照组(n=51)。对照组患者采用硫酸镁注射液治疗,观察组在对照组治疗基础上采用硝苯地平缓释片,均持续治疗2周。对比2组治疗前后血压变化情况,比较2组治疗前后一氧化氮、丙二醛(malondialdehyde, MDA)及超氧化物歧化酶(superoxide dismutase, SOD)等氧化应激指标水平及肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、超敏C反应蛋白(high-sensitivity C-reactive protein, hs-CRP)及白细胞介素-6(interleukin-6,IL-6)等微环境炎症因子水平的变化。记录2组患者治疗期间不良反应发生情况并观察2组患者的母婴结局。结果 治疗后,2组HDP患者收缩压(systolic pressure, SBP)与舒张压(diastolic pressure, DBP)较治疗前均明显下降(P<0.05),且观察组HDP患者SBP、DBP下降的程度明显高于对照组(P<0.05);观察组HDP患者一氧化氮、SOD下降程度及MDA升高程度明显优于对照组,组间差异具有统计学意义(P<0.05);观察组HDP患者血清TNF-α、hs-CRP及IL-6水平较对照组明显降低(P<0.05);观察组HDP患者治疗期间不良反应发生率(19.61%)与对照组(11.76%)的差异无统计学意义;观察组HDP患者产后出血率、胎儿窘迫率(分别为5.88%和3.92%)明显低于对照组(21.57%和15.69%),自然分娩率(80.39%)明显高于对照组(62.75%)(P<0.05)。结论 硝苯地平联合硫酸镁治疗HDP疗效确切,可有效降低患者的血压,减少氧化应激,减轻微环境炎症,改善母婴结局,且安全性高。

Objective To explore the effects of nifedipine combined with magnesium sulfate on oxidative stress, micro-environmental inflammation and maternal and neonatal outcomes in hypertensive disorders of pregnancy(HDP).Methods According to simple random grouping method, 102 patients with HDP were enrolled and divided into observation group(n=51) and control group(n=51). The control group was treated with Magnesium Sulfate Injections, while the observation group was additionally treated with Nifedipine Sustained-release Tablets. All were continuously treated for 2 weeks. The changes in levels of blood pressure, oxidative stress indexes [nitric oxide(NO), malondialdehyde(MDA), superoxide dismutase(SOD)] and micro-environmental inflammatory factors [tumor necrosis factor-α(TNF-α), high-sensitivity C-reactive protein(hs-CRP), interleukin-6(IL-6)] before and after treatment were compared between the 2 groups. The occurrence of adverse reactions during treatment in both groups was recorded, and maternal and neonatal outcomes were observed.Results After treatment, the levels of systolic blood pressure(SBP) and diastolic blood pressure(DBP) in both groups were significantly decreased(P<0.05), which were significantly lower in observation group than in control group(P<0.05). The decrease of NO and SOD, and increase of MDA in observation group were significantly better than those in control group(P<0.05). The levels of serum TNF-α, hs-CRP and IL-6 in observation group were significantly lower than those in control group(P<0.05). The difference in the incidence of adverse reactions during treatment between observation group and control group was not statistically significant(19.61% vs. 11.76%). The incidence rates of postpartum hemorrhage and fetal distress in observation group were 5.88% and 3.92%, significantly lower than those in control group(21.57%, 15.69%), while the natural delivery rate was significantly higher than that in control group(80.39% vs. 62.75%)(P<0.05).Conclusion The curative effect of nifedipine combined with magnesium sulfate is significant on HDP, which can effectively lower blood pressure, reduce oxidative stress, alleviate micro-environmental inflammation, and improve maternal and neonatal outcomes, with high safety.