硝苯地平缓释片联合硫酸镁治疗妊娠期高血压疾病的临床效果

Therapeutic effects of nifedipine sustained-release tablets combined with magnesium sulfate on hypertensive disorders of pregnancy

目的分析硝苯地平缓释片联合硫酸镁治疗妊娠期高血压疾病(HDCP)的效果及对血管内皮功能、母婴结局的影响。方法抽取2020年10月至2022年5月河南科技大学附属许昌市中心医院收治的HDCP患者72例,随机分为对照组和联合组,每组36例。对照组给予硫酸镁进行治疗,联合组给予硝苯地平缓释片+硫酸镁进行治疗。比较两组临床疗效、收缩压、舒张压、24 h尿蛋白量、子宫动脉血流参数[收缩期最大流速(Vmax)、收缩期峰值流速/舒张末期流速(S/D)、阻力指数(RI)、搏动指数(PI)]、血管内皮功能[可溶性血管内皮生长因子受体-1(sFlt-1)、内皮素1(ET-1)、一氧化氮(NO)、可溶性内皮因子(sEng)]及母婴结局。结果联合组总有效率(91.67%,33/36)高于对照组(72.22%,26/36),P<0.05。干预后,两组收缩压、舒张压、24 h尿蛋白量、PI、S/D、RI均较干预前降低,且联合组上述指标均低于对照组;两组Vmax均较干预前升高,且联合组Vmax高于对照组(P<0.05)。干预后,两组sEng、ET-1、sFlt-1均较干预前降低,NO均较干预前升高,且联合组sEng、ET-1、sFlt-1低于对照组,联合组NO高于对照组(P<0.05)。联合组不良母婴结局发生率(13.89%,5/36)低于对照组(36.11%,13/36),P<0.05。结论硝苯地平缓释片联合硫酸镁可降低HDCP患者的血压水平,减少不良母婴结局,并改善血管内皮功能。

Objective To analyze the clinical effects of nifedipine sustained-release tablets combined with magnesium sulfate in the treatment of hypertensive disorders of pregnancy(HDCP),and its influence on vascular endothelial function,maternal and infant outcomes.Methods A total of 72 patients with HDCP admitted to Xuchang Central Hospital Affiliated to Henan University of Science and Technology from October 2020 to May 2022 were selected as study subjects,and they were randomly divided into control group and combination group,with 36 cases in each group.The control group was treated with magnesium sulfate,while the combination group was treated with nifedipine sustained-release tablets combined with magnesium sulfate.The clinical efficacy,systolic blood pressure,diastolic blood pressure,24-hour urine protein content,uterine artery blood flow parameters,including systolic maximum flow velocity(Vmax),peak systolic velocity/end diastolic(S/D),resistance index(RI)and pulsatility index(PI),vascular endothelial function,assessed by soluble Fms-like tyrosine kinase 1(sFlt-1),endothelin-1(ET-1),nitric oxide(NO)and soluble endoglin(sEng),and outcomes of maternal and infant were compared between the two groups.Results The total effective rate of the combination group(91.67%,33/36)was higher than that of the control group(72.22%,26/36),P<0.05.After intervention,the systolic blood pressure,diastolic blood pressure,24-hour urine protein content,PI,S/D,and RI of both groups decreased,compared with these indexes before intervention(P<0.05);and the above indicators in the combination group were lower than those in the control group(P<0.05).After intervention,the Vmax of both groups were higher than those before intervention,and the Vmax of the combination group was higher than that of the control group(P<0.05).After intervention,the levels of sEng,ET-1 and sFlt-1 in both groups were lower than those before intervention,while the levels of NO in both groups were higher(P<0.05);and the levels of sEng,ET-1 and sFlt-1 in the combination group were lower than those in the control group,while the levels of NO in the combination group was higher than that in the control group(P<0.05).The incidence of adverse maternal and infant outcomes in the combination group(13.89%,5/36)was lower than that in the control group(36.11%,13/36),P<0.05.Conclusions The combination of nifedipine sustained-release tablets and magnesium sulfate in the treatment of HDCP can lower the patient’s blood pressure level,reduce adverse maternal and infant outcomes,and improve the patient’s vascular endothelial function.