L-精氨酸对妊高征的治疗作用及其机制的探讨

Effect and Mechanism of L-Arginine in treating Pregnancy Induced Hypertension Syndrome

目的 :探讨硫酸镁和L 精氨酸联合治疗妊高症的有效性。方法 :设立对照组和妊高征组并利用硫酸镁、L 精氨酸及联合用药 (硫酸镁 +L 精氨酸 )治疗 ,观察其动态血压和 2 4h尿蛋白定量及一氧化氮 (NO)、一氧化氮合酶 (NOS)、内皮素 (ET)、血管紧张素Ⅱ (ANGⅡ )、血栓烷 (TXA2 )、前列环素 (PGI2 )等指标的变化。结果 :与对照组比较 ,妊高征组NO、PGI2 含量及NOS活性明显降低 (P <0 .0 1) ,ET、ANGⅡ及TXA2 明显升高 (P <0 .0 1)。中度与重度妊高征组治疗前后NO、NOS、TXB2 、AngⅡ水平比较 ,有显著性差异 (P <0 .0 5 ) ,而ET水平在中度与重度妊高征组相比较P <0 .0 1。联合用药组临床疗效明显优于硫酸镁组和L 精氨酸组 (P <0 .0 1)。结论 :NO水平、NOS活性降低及血管调节因子失衡 ,可能为妊高征的发病因素 ;L 精氨酸联合硫酸镁对妊高征有明显的治疗作用 。

Objective: To examine the validity of combination of L-arginine and magnesium sulfate in treating pregnancy-induced hypertension syndrome (PIH). Method: It was established the control group and PIH group with magnesium sulfate, L-arginine, and then observed dynamic changes of blood pressure, urine protein in 24 hours, NO, NOs, ET, ANG Ⅱ, TXA 2 and PGI 2.Results: Compared with control group, the content of NO and PGI 2, the activity of NOS decreased (P<0.01) among PIH group, while ET, ANG Ⅱ, and TXA2 increased (P<0.01). In moderate PIH group and severe PIH group, the levels of NO, NOS, TXB 2,ANG Ⅱ and ET are notably different between pretreatment and post treatment (P<0.05). The clinical effect of combined medication group was obviously more effective than treated with magnesium sulfate or L-arginine respectively (P<0.05).Conclusion: The pathogenesis of PIH might be the decrease of level of NO, activity of NOS and disequilibrium of blood vessel regulating factors. The combination of L-arginine and magnesium sulfate is effective for PIH, so this study provides a new way for PIH therapy.