酚妥拉明及硝苯地平与硫酸镁联合治疗对妊娠期高血压患者凝血功能及妊娠结局的影响

Effects of Phentolamine and Nifedipine Combined with Magnesium Sulfate on Coagulation Function and Pregnancy Outcome in Hypertensive Patients During Pregnancy

目的探讨酚妥拉明及硝苯地平与硫酸镁联合治疗妊娠期高血压患者的应用效果。方法选取2020年2月—2023年2月青岛市城阳区人民医院收治的82例妊娠期高血压患者为研究对象,按随机数字表法将其分为对照组和观察组,各41例。对照组采用硫酸镁治疗,观察组在对照组的基础上联合酚妥拉明及硝苯地平治疗,两组均连续治疗7 d后观察治疗情况,并随访至分娩后。比较两组的血压水平、凝血功能、血液流变学指标、妊娠结局及不良反应发生情况。结果治疗后,观察组收缩压及舒张压均低于对照组,组间差异有统计学意义(P<0.05);观察组凝血酶、凝血酶原及活化部分凝血活酶时间均长于对照组,纤维蛋白原低于对照组,组间差异有统计学意义(P<0.05);观察组全血高切黏度、全血低切黏度及血浆黏度均低于对照组,组间差异有统计学意义(P<0.05)。观察组不良妊娠结局发生率为4.88%,低于对照组的21.95%,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论酚妥拉明及硝苯地平与硫酸镁联用可降低妊娠期高血压患者血压水平,调节其凝血功能及体内血液流变学指标,改善妊娠结局,且药物安全性良好。

Objective To explore the effect of phentolamine and nifedipine combined with magnesium sulfate in the treatment of hypertensive patients during pregnancy.Methods A total of 82 patients with gestational hypertension treated in Chengyang District People's Hospital of Qingdao from February 2020 to February 2023 were selected as the research objects,and were divided into a control group and an observation group according to random number table method,with 41 cases in each group.The control group was treated with magnesium sulfate,and the observation group was combined with phentolamine and nifedipine on the basis of the control group.The treatment status of both groups was observed after continuous treatment for 7 days,and follow-up was conducted until after delivery.Blood pressure level,coagulation function,hemorheology indicators,pregnancy outcome and adverse reactions were compared between the two groups.Results After treatment,the systolic blood pressure and diastolic blood pressure in the observation group were lower than those in the control group,and the differences between the groups were statistically significant(P<0.05);the time of thrombin,prothrombin and activated partial thromboplastin in observation group were longer than those in control group,but the time of fibrinogen was lower than that in control group,and the differences between the groups were statistically significant(P<0.05);whole blood high tangential viscosity,whole blood low tangential viscosity and plasma viscosity in observation group were lower than those in control group,and the differences between the groups were statistically significant(P<0.05).The incidence of adverse pregnancy outcome in the observation group was 4.88%,which was lower than 21.95% in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The combination of phentolamine and nifedipine with magnesium sulfate can reduce the blood pressure level of hypertensive patients during pregnancy,regulate the coagulation function and hemorheology indicatiors in vivo,improve the pregnancy outcome,and the drug safety is good.