摘要
目的观察拉贝洛尔联合拜新同对慢性高血压伴子痫前期患者分娩情况及患者血清中妊娠相关血浆蛋白A(PAPP-A)、血清白血病抑制因子(LIF)水平的影响。方法随机选取2017年5月-2019年6月于我院就诊的符合诊断标准的慢性高血压并子痫前期的孕妇118例,按照随机数字表法分为对照组(n=59例)和观察组(n=59例)。对照组给予硝苯地平控释片30mg,每日1次。观察组在对照组及基础上给予盐酸拉贝洛尔200mg。两组患者均随访6个月。对两组患者进行为期6个月的随访,分别记录两组患者治疗前、治疗3个月后及治疗6个月后的血压。分别于治疗前及治疗后2w测量两组患者血清中PAPP-A及LIF水平。记录两组患者围产期不良结局及整个用药期间不良反应的发生率。结果治疗前,两组患者收缩压及舒张压无明显差异(P>0.05),两组患者PAPP-A及LIF水平均无明显差异(P>0.05)。经过2w的治疗,两组患者PAPP-A水平均下降(P<0.05),且观察组均低于对照组(t=8.245,P=0.000);两组患者LIF水平均增加(P<0.05),且观察组均高于对照组(t=5.555,P=0.000)。治疗3个月及6个月后,两组患者收缩压及舒张压均下降(P<0.05),且观察组均低于对照组(P<0.05)。观察组围产期不良结局总发生率明显低于对照组(χ2=3.890,P=0.049)。两组患者失访率分别为93.22%(55/59)和89.83%(53/59)(χ2=0.440,P=0.509)。两组患者的不良反应发生率无差异(χ2=2.360,P=0.087)。结论拉贝洛尔联合拜新同治疗慢性高血压伴子痫前期患者,可显著降低患者的血压,降低患者围产期不良结局的风险,改善胎盘-子宫组织的氧供和血供及减轻血管内皮的损伤,且不良反应少。
Objective:To observe the effect of Labetol combined with Baixin on delivery and serum levels of pregnancy-associated plasma protein A(PAPP-A)and serum leukemia inhibitor(LIF)in patients with chronic hypertension and preeclampsia.Method:From May 2017 to June 2019,118 pregnant women with chronic hypertension complicated with preeclampsia were randomly divided into control group(n=59)and observation group(n=59).The control group was given nifedipine controlled release tablets 30 mg once a day.The observation group was given rabeprolol hydrochloric acid 200 mg on the basis of the control group and on the basis of the control group.Both groups were followed up for 6 months.The patients in the two groups were followed up for 6 months.The blood pressure of the two groups before treatment,3 months after treatment and 6 months after treatment were recorded respectively.Serum PAPP-A and LIF levels were measured before and 2 weeks after treatment.The adverse perinatal outcomes and the incidence of adverse reactions were recorded in both groups.Results:Before treatment,there was no significant difference in systolic and diastolic blood pressure between the two groups,but there was no significant difference in PAPP-A and LIF levels between the two groups.After 2 weeks of treatment,the level of PAPP-A in both groups decreased(P<0.05),and that in the observation group was lower than that in the control group(t=8.248,P=0.000).The level of LIF in both groups was higher than that in control group(P<0.05),and it was higher in the observation group than that in the control group(t=5.555,P=0.000).After 3 and 6 months of treatment,systolic and diastolic blood pressure decreased in both groups(P<0.05),and the systolic and diastolic blood pressure in the observation group was lower than that in the control group(P<0.05).The total incidence of adverse outcomes in the observation group was significantly lower than that in the control group(χ~2=3.890,P=0.049).The loss of visit rate of the two groups was 93.22%(55/59)and 89.83%(53/59),respectively(χ~2=0.440,P=0.509).There was no difference in the incidence of adverse reactions between the two groups(χ~2=2.360,P=0.087).Conclusion:Rabelol combined with Baixin in the treatment of chronic hypertension with preeclampsia can significantly reduce the blood pressure of the patients,reduce the risk of adverse outcomes in the perioperative period,improve the oxygen supply and blood supply of placenta and uterus,and reduce the injury of vascular endothelial cells,with few adverse reactions.
作者
李瑾
潘晶
LI Jin;PAN Jing(Kunshan First People's Hospital,Kunshan,Jiangsu 215300)
出处
《中国优生与遗传杂志》
2020年第4期479-481,498,共4页
Chinese Journal of Birth Health & Heredity
作者简介
通讯作者:潘晶
