低分子量肝素钠注射液联合硫酸镁注射液和拉贝洛尔片治疗重度妊娠期高血压综合征的临床研究
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摘要
目的观察低分子量肝素钠注射液联合硫酸镁注射液和拉贝洛尔片治疗重度妊娠期高血压综合征的临床疗效及安全性。方法将158例重度妊娠期高血压综合征患者随机分为对照组和试验组,每组79例。对照组予以拉贝洛尔每次0. 1 g,bid,口服+硫酸镁负荷剂量5. 0 g,30 min静脉滴注,之后予以硫酸镁注射液15. 0 g,qd,在6～8 h内静脉滴注;试验组在对照组治疗的基础上,予以低分子量肝素钠每次5000 U,q12 h,皮下注射。2组患者均治疗5 d。比较2组患者的临床疗效、血压水平,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为94. 94%(75例/79例)和75. 95%(60例/79例),差异有统计学意义(P <0. 05)。治疗后,试验和对照组的收缩压分别为(145. 41±5. 34)和(156. 02±6. 13) mm Hg,舒张压分别为(102. 37±4. 83)和(113. 54±5. 15) mm Hg,平均动脉压分别为(94. 55±3. 85)和(111. 17±5. 37)mm Hg,差异均有统计学意义(均P <0. 05)。2组患者发生的药物不良反应主要有心悸、脸红、下肢水肿和心动过缓,试验组和对照组的总药物不良反应发生率分别为8. 87%和12. 66%,差异无统计学差异(P> 0. 05)。结论低分子量肝素钠注射液联合硫酸镁注射液和拉贝洛尔片治疗重度妊娠期高血压综合征的临床疗效确切,且不增加药物不良反应的发生率。
Objective To observe the clinical efficacy and safety of low-molecular-weight heparin sodium injection combined with magnesium sulfate injection and labelol tablets in the treatment of severe pregnancy induced hypertension. Methods A total of 158 patients with severe pregnancy induced hypertension were randomly divided into control and treatment groups with 79 cases per group. Control group received labetalol 0. 1 g each time,bid,orally + magnesium sulfate loading dose 5. 0 g,intravenous drip in 30 min,and followed by intravenous drip of magnesium sulfate injection 15. 0 g within 6-8 h,qd. Treatment group was given low-molecular-weight heparin sodium 5000 U each time,q12 h,subcutaneous injection,on the basis of control group. Two groups were treated for 5 d. The clinical efficacy,blood pressure and adverse drug reactions were compared between two groups. Results After treatment,the total effective rates of treatment and control groups were 94. 94%( 75 cases/79 cases) and 75. 95%( 60 cases/79 cases) with significant difference( P < 0. 05). After treatment,the main indexes of treatment and control groups were compared: systolic blood pressure were( 145. 41 ± 5. 34) and( 156. 02 ± 6. 13) mm Hg,diastolic blood pressure were( 102. 37 ± 4. 83) and( 113. 54 ± 5. 15) mm Hg, mean arterial pressure were( 94. 55 ± 3. 85) and( 111. 17 ± 5. 37) mm Hg,the differences were statistically significant( all P < 0. 05). The adverse drug reactions of two groups were palpitation,blushing,edema of the lower extremities and bradycardia. The total incidences of adverse drug reactions in the treatment and control groups were 8. 87% and 12. 66% without significant difference( P > 0. 05).Conclusion Low-molecular-weight heparin sodium injection combined with magnesium sulfate injection and labelol tablets has a definitive clinical efficacy in the treatment of severe pregnancy induced hypertension,without increasing the incidence of adverse drug reactions.
Objective To observe the clinical efficacy and safety of low-molecular-weight heparin sodium injection combined with magnesium sulfate injection and labelol tablets in the treatment of severe pregnancy induced hypertension. Methods A total of 158 patients with severe pregnancy induced hypertension were randomly divided into control and treatment groups with 79 cases per group. Control group received labetalol 0. 1 g each time,bid,orally + magnesium sulfate loading dose 5. 0 g,intravenous drip in 30 min,and followed by intravenous drip of magnesium sulfate injection 15. 0 g within 6-8 h,qd. Treatment group was given low-molecular-weight heparin sodium 5000 U each time,q12 h,subcutaneous injection,on the basis of control group. Two groups were treated for 5 d. The clinical efficacy,blood pressure and adverse drug reactions were compared between two groups. Results After treatment,the total effective rates of treatment and control groups were 94. 94%( 75 cases/79 cases) and 75. 95%( 60 cases/79 cases) with significant difference( P < 0. 05). After treatment,the main indexes of treatment and control groups were compared: systolic blood pressure were( 145. 41 ± 5. 34) and( 156. 02 ± 6. 13) mm Hg,diastolic blood pressure were( 102. 37 ± 4. 83) and( 113. 54 ± 5. 15) mm Hg, mean arterial pressure were( 94. 55 ± 3. 85) and( 111. 17 ± 5. 37) mm Hg,the differences were statistically significant( all P < 0. 05). The adverse drug reactions of two groups were palpitation,blushing,edema of the lower extremities and bradycardia. The total incidences of adverse drug reactions in the treatment and control groups were 8. 87% and 12. 66% without significant difference( P > 0. 05).Conclusion Low-molecular-weight heparin sodium injection combined with magnesium sulfate injection and labelol tablets has a definitive clinical efficacy in the treatment of severe pregnancy induced hypertension,without increasing the incidence of adverse drug reactions.
引文
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[7]刘晋仙,李玮涛,张在忠,等.低分子肝素药理学机制及适应证研究进展[J].药学研究,2015,58(7):420-421.
[8]廖运先,王晨虹.妊娠期高血压疾病硫酸镁及降压药的应用[J].中国计划生育和妇产科,2016,8(5):6-8.
[2]王莹.妊娠期高血压疾病的相关因素研究进展[J].包头医学院学报,2014,30(1):147-148.
[3]赵雪峰,杨万杰.妊娠期高血压疾病严重并发症的研究进展[J].医学综述,2015,22(12):2209-2211.
[4]洪展桐,张琳,周绮娴,等.凝血功能指标检测对妊娠期高血压疾病的临床价值分析[J].检验医学与临床,2015,16(14):1992-1993.
[5]杨孜,张为远.妊娠期高血压疾病诊治指南(2015)[J].中华妇产科杂志,2015,50(10):721-728.
[6] MAGEE L A,PELS A,HELEWA M,et al. Diagnosis,evaluation,and management of the hypertensive disorders of pregnancy[J].Pregnancy Hypertens,2014,36(5):416.
[7]刘晋仙,李玮涛,张在忠,等.低分子肝素药理学机制及适应证研究进展[J].药学研究,2015,58(7):420-421.
[8]廖运先,王晨虹.妊娠期高血压疾病硫酸镁及降压药的应用[J].中国计划生育和妇产科,2016,8(5):6-8.