硝苯地平联合依诺肝素钠对重度子痫前期术后妊娠期高血压患者的应用效果

Application of nifedipine combined with enoxaparin sodium in patients with gestational hypertension after severe preeclampsia surgery

目的探讨硝苯地平联合依诺肝素钠对重度子痫前期术后妊娠期高血压患者的应用效果及纤溶酶原激活剂抑制因子(PAI-1)、血小板计数(PLT)水平的影响。方法研究对象来源于2020年6月至2022年7月行剖宫产的重度子痫前期孕妇100例,按照随机数字表法另为对照组和试验组,每组50例。2组均在常规治疗基础上展开分组治疗,其中对照组口硝苯地平治疗,试验组采用硝苯地平联合依诺肝素钠治疗,对比组间临床疗效、血压和尿蛋白量变化、血清[纤溶酶原激活剂抑制因子(PAI-1)、血小板计数(PLT)]水平变化以及母婴不良结局发生率的差异。结果试验组临床总有效率高于对照组(P<0.05)。治疗1个周期后,试验组产妇DBP、SBP以及24 h尿蛋白量都较对照组降低(P<0.05)。试验组产妇治疗1个周期后的血清PAI-1、PLT水平都较治疗前与对照组显著降低(P<0.05)。试验组母婴不良结局发生率低于对照组(P<0.05)。结论硝苯地平联合依诺肝素钠治疗重度子痫前期可进一步提高临床疗效,促进患者凝血功能的改善,从而降低母婴不良结局发生率,有利于促进母婴预后以及生活质量的提升,建议推广应用。

Objective To investigate the application effect of nifedipine combined with enoxaparin sodium on patients with gestational hypertension after severe preeclampsia and its regulatory effects on plasminogen activator inhibitor(PAI11)and platelet count(PLT).Methods A total of 100 pregnant women with severe preeclampsia who underwent cesarean section in the obstetrics department of our hospital from June 2020 to July 2022 were recruited.They were randomly assigned into control group(n=50)and experimental group(n=50).Conventional treatment was performed in all recruited patients,and those in control group and experimental group were given oral nifedipine,and nifedipine combined with enoxaparin sodium,respectively.The clinical efficacy,blood pressure and urinary protein,serum plasminogen activator inhibitor-1(PAI-1),platelet count(PLT),and adverse maternal and infant outcomes rate were included as comparisons between groups.Results The total clinical effective rate was significantly higher in the experimental group than that in the control group(P<0.05).After one cycle of treatment,the diastolic blood pressure(DBP),systolic blood pressure(SBP)and 24-hour urine protein levels in the experimental group were significantly lower than those in the control group(P<0.05).The serum levels of PAI-1 and PLT in the experimental group after one cycle of treatment were significantly lower than those before treatment and synchronous the control group(P<0.05).The incidence of adverse maternal and infant outcomes was significantly lower in the experimental group than in the control group(P<0.05).Conclusion The combination of nifedipine and enoxaparin sodium significantly enhances the efficacy on severe preeclampsia,which improves the coagulation function and reduces the incidence of adverse maternal and infant outcomes.It is favorable to maternal and infant prognosis and the quality of life,and deserves clinical application.