硝苯地平缓释片对妊娠期高血压患者重要指标的影响

Influence of Nifedipine Sustained-release Tablets on important indices in pregnancy-induced hypertension patients

目的探讨硝苯地平缓释片对妊娠期高血压(pregnancy-induced hypertension,PIH)患者血清抗氧化指标、同型半胱氨酸(homocysteine,Hcy)和胱抑素C(cystatin C,CysC)的影响。方法选取142例PIH患者作为PIH组,选取同期60例健康妊娠期妇女作为对照组。PIH组采用硝苯地平缓释片治疗。比较2组的收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、血清超氧化物歧化酶(serum superoxide dismutase,SOD)、谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-Px)、丙二醛(malondialdehyde,MDA)、Hcy和CysC的水平,测定脐动脉阻力指数(resistance index,RI)、搏动指数(pulsatility index,PI)、收缩末期与舒张末期血流速度比(end-systolic and end-diastolic blood flow velocity ratio,S/D)。结果治疗前,PIH组的血清SOD和GSH-Px水平均低于对照组,SBP、DBP、Hcy、CysC水平及脐动脉RI、PI和S/D值均高于对照组(P<0.05)。治疗后,PIH组的SBP和BDP水平均显著下降,血清SOD和GSH-Px水平均显著升高,Hcy和CysC水平及脐动脉RI、PI和S/D值均显著降低(P<0.05)。PIH组的剖宫产率(31.69%)和早产率(13.38%)显著高于对照组的剖宫产率(18.33%)和早产率(3.33%)(P<0.05);且PIH组的新生儿1 min Apgar评分低于对照组(P<0.05),2组胎盘早剥、产后出血、胎儿及新生儿窒息率比较差异均无统计学意义(P>0.05)。结论PIH患者存在明显的抗氧化力下降及血清Hcy和CysC高表达,硝苯地平缓释片治疗能够改善患者的抗氧化能力、下调血清Hcy和CysC水平,改善脐动脉血流灌注和妊娠结局。

Objective To investigate the influence of Nifedipine Sustained-release Tablets on important indices such as serum antioxidant indices,homocysteine(Hcy)and cystatin C(CysC)in patients with pregnancy-induced hypertension(PIH).Methods A total of 142 patients with PIH were selected as the PIH group,and 60 healthy pregnant women during the same period were selected as the control group.The PIH group received Nifedipine Sustained-release Tablets for 4 weeks.The systolic blood pressure(SBP),diastolic blood pressure(DBP),serum superoxide dismutase(SOD),glutathione peroxidase(GSH-Px),malondialdehyde(MDA),and the levels Hcy and CysC of the 2 groups were compared,and the umbilical artery resistance index(RI),pulsatility index(PI),end-systolic and end-diastolic blood flow velocity ratio(S/D)were determined.Results The serum levels of SOD and GSH-Px of the PIH group were lower than those of the control group,and the SBP,DBP,the levels of Hcy and CysC and the values of umbilical artery RI,PI and S/D were higher than those of the control group(P<0.05).After 4 weeks of treatment in the PIH group,the SBP and BDP were significantly decreased,the serum SOD and GSH-Px levels were significantly increased,and the levels of Hcy and CysC and the values of umbilical artery RI,PI and S/D were significantly decreased(P<0.05).The cesarean section rate and premature delivery rate in the PIH group were 31.69%and 13.38%,respectively,which were significantly higher than 18.33%and 3.33%in the control group(P<0.05).The 1 minute Apgar score of the newborns in the PIH group was lower than that in the control group(P<0.05).There was no significant difference in the rates of placental abruption,postpartum hemorrhage,fetal and neonatal asphyxia between the 2 groups(P>0.05).Conclusion PIH patients have a significant decrease in antioxidant capacity and high expression of serum Hcy and CysC.Nifedipine Sustained-release Tablets treatment can improve antioxidant capacity,down-regulate serum Hcy and CysC levels,improve umbilical artery blood perfusion,and improve pregnancy outcome.