硝苯地平控释片联合盐酸拉贝洛尔治疗妊娠高血压综合征的效果及安全性

Efficacy and safety of nifedipine extended-release tablets combined with labetalol hydrochloride in the treatment of pregnancy-induced hypertension syndrome

目的探讨硝苯地平控释片联合盐酸拉贝洛尔治疗妊娠高血压综合征(PIH)的效果及安全性。方法回顾性抽取2020年4月至2023年1月西安交通大学第一附属医院收治的PIH患者103例,按照治疗方案将其分为对照组(50例,予以盐酸拉贝洛尔治疗)和联合组(53例,予以盐酸拉贝洛尔+硝苯地平控释片治疗)。治疗4周后,比较两组疗效、血压、肾功能[血尿素氮(BUN)、24 h尿蛋白量]、血管活性物质[血管内皮素-1(ET-1)、血栓素A2(TXA2)、一氧化氮(NO)、前列环素I2(PGI2)]水平、不良反应及不良妊娠结局发生率。结果治疗4周后,联合组总有效率(96.23%,51/53)高于对照组(82.00%,41/50),血压、BUN、24 h尿蛋白量低于对照组,NO、PGI2高于对照组,ET-1、TXA2低于对照组(P均<0.05)。两组不良反应及不良妊娠结局发生率比较差异未见统计学意义(P>0.05)。结论硝苯地平控释片联合盐酸拉贝洛尔治疗PIH疗效确切,可有效抑制血管内皮损伤,降低血压,减少蛋白尿,且有一定安全性。

Objective To investigate the effects and safety of nifedipine extended-release tablets combined with labetalol hydrochloride in the treatment of pregnancy-induced hypertension syndrome(PIH).Methods A total of 103 PIH patients admitted to the First Affiliated Hospital of Xi’an Jiaotong University from April 2020 to January 2023 were retrospectively selected,and they were divided into a control group(50 cases,treated with labetalol hydrochloride)and a combined group(53 cases,treated with labetalol hydrochloride combined with nifedipine extended-release tablets)according to the treatment plan.After 4 weeks of treatment,the two groups were compared in terms of treatment efficacy,blood pressure,renal function assessed by blood urea nitrogen(BUN)and 24-hour urine protein,the levels of vasoactive substances including vascular endothelin-1(ET-1),thromboxane A2(TXA2),nitric oxide(NO)and prostacyclin I2(PGI2),incidence of adverse reactions and incidence of adverse pregnancy outcomes.Results After 4 weeks of treatment,the combined group had a higher total effective rate(96.23%,51/53)compared with the control group(82.00%,41/50),P<0.05;the comnined group had lower levels of blood pressure,BUN and 24-hour urine protein compared with the control group(all P<0.05).After 4 weeks of treatment,the levels of NO and PGI2 in the combined group were higher than those in the control group,while the levels of ET-1 and TXA2 in the combined group were lower than those in the control group(all P<0.05).There was no significant difference in the incidence of adverse reactions and adverse pregnancy outcomes between the two groups(P>0.05).Conclusions Nifedipine extended-release tablets combined with labetalol hydrochloride has a definite effect in the treatment of PIH,which can effectively inhibit vascular endothelial damage,decrease blood pressure,and reduce proteinuria,with certain safety.