小剂量阿司匹林与丹参注射液配伍对妊娠高血压患者血液流变学、血管内皮功能及氧化应激水平的影响
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摘要
目的:探讨小剂量阿司匹林与丹参注射液配伍对妊娠高血压患者血液流变学、血管内皮功能及氧化应激水平的影响。方法:选取在我院进行治疗的妊娠高血压患者180例为研究对象,随机分为对照组和观察组,每组90例。对照组给予常规治疗,观察组在对照组的基础上给予小剂量阿司匹林联合丹参注射液治疗,之后对两组患者血液流变学、血管内皮功能及氧化应激指标进行检测。结果:治疗后,两组MAP及24hUpro水平较治疗前均明显降低(P<0.05),且治疗后比较观察组MAP及24hUpro水平显著低于对照组(P<0.05);治疗后,PT水平较治疗前明显升高(P<0.05),而D-D及Fg水平则较治疗前明显降低(P<0.05),对两组治疗后进行组间比较发现,观察组PT水平明显高于对照组(P<0.05),D-D及Fg水平均则明显低于对照组(P<0.05);治疗后,两组NO水平较治疗前显著升高,ET-1和ET-1/NO水平则较治疗前明显降低(P<0.05),对两组治疗后ET-1、NO及ET-1/NO水平比较之后发现,观察组NO水平明显高于对照组(P<0.05),而ET-1和ET-1/NO水平则明显低于对照组(P<0.05);与治疗前相比,治疗后两组SOD明显升高(P<0.05),MDA明显降低(P<0.05),对两组治疗之后SOD及MDA水平分析发现,观察组SOD水平较对照组显著增加(P<0.05),而MDA水平则较对照组显著降低(P<0.05)。结论:小剂量阿司匹林与丹参注射液配伍治疗妊娠期高血压能有效改善患者血液流变学指标及血管内皮功能,降低患者氧化应激损伤,值得临床进一步推广。
Objective:To investigate the effect of low dose aspirin and salvia miltiorrhiza injection on hemorrheology,endothelial function and oxidative stress in patients with pregnancy induced hypertension.Methods:A total of 180 pregnancyinduced hypertension patients treated in our hospital from April 2015 to November 2016 were selected as study subjects and randomly divided into control group and observation group with 90 cases in each group.The control group was given routine treatment.The observation group was treated with low-dose aspirin plus Salvia miltiorrhiza in the control group.After treatment,blood rheology,vascular endothelial function and oxidative stress were measured in two groups.Results:The levels of MAP and 24 h Upro in both groups were significantly lower than those before treatment(P <0.05).After treatment,the MAP and 24 hUpro levels in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the level of PT was significantly higher than that before treatment(P<0.05),while the level of DD and Fg was significantly lower than that before treatment(P<0.05).Comparing the two groups after treatment showed that the PT level(P<0.05),and the levels of DD and Fg were significantly lower than those in the control group(P<0.05);After treatment,NO levels in both groups were significantly higher than those before treatment,ET-1 and ET-1/NO levels were significantly lower than before treatment(P<0.05),after treatment,ET-1,NO and ET The NO level in the observation group was significantly higher than that in the control group(P<0.05),while ET-1 and ET-1/NO levels were significantly lower than those in the control group(P<0.05);Compared with those before treatment,the levels of SOD in the two groups were significantly increased(P<0.05)and MDA significantly decreased after treatment(P<0.05).The SOD and MDA levels in the two groups after treatment showed that the SOD level in the observation group was significantly higher than that in the control group(P<0.05),while MDA level was significantly lower than that of the control group(P<0.05).Conclusion:The combination of lowdose aspirin and Salvia miltiorrhiza injection has significant therapeutic effect on gestational hypertension,and can effectively improve the hemorheological parameters and endothelial function of patients and reduce the oxidative stress injury in patients.It is worth further clinical promotion.
Objective:To investigate the effect of low dose aspirin and salvia miltiorrhiza injection on hemorrheology,endothelial function and oxidative stress in patients with pregnancy induced hypertension.Methods:A total of 180 pregnancyinduced hypertension patients treated in our hospital from April 2015 to November 2016 were selected as study subjects and randomly divided into control group and observation group with 90 cases in each group.The control group was given routine treatment.The observation group was treated with low-dose aspirin plus Salvia miltiorrhiza in the control group.After treatment,blood rheology,vascular endothelial function and oxidative stress were measured in two groups.Results:The levels of MAP and 24 h Upro in both groups were significantly lower than those before treatment(P <0.05).After treatment,the MAP and 24 hUpro levels in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the level of PT was significantly higher than that before treatment(P<0.05),while the level of DD and Fg was significantly lower than that before treatment(P<0.05).Comparing the two groups after treatment showed that the PT level(P<0.05),and the levels of DD and Fg were significantly lower than those in the control group(P<0.05);After treatment,NO levels in both groups were significantly higher than those before treatment,ET-1 and ET-1/NO levels were significantly lower than before treatment(P<0.05),after treatment,ET-1,NO and ET The NO level in the observation group was significantly higher than that in the control group(P<0.05),while ET-1 and ET-1/NO levels were significantly lower than those in the control group(P<0.05);Compared with those before treatment,the levels of SOD in the two groups were significantly increased(P<0.05)and MDA significantly decreased after treatment(P<0.05).The SOD and MDA levels in the two groups after treatment showed that the SOD level in the observation group was significantly higher than that in the control group(P<0.05),while MDA level was significantly lower than that of the control group(P<0.05).Conclusion:The combination of lowdose aspirin and Salvia miltiorrhiza injection has significant therapeutic effect on gestational hypertension,and can effectively improve the hemorheological parameters and endothelial function of patients and reduce the oxidative stress injury in patients.It is worth further clinical promotion.
引文
1 郑晓瑛,姚静,朱加美,等.丹参注射液联合小剂量阿司匹林对妊娠期高血压疾病患者氧自由基和血管内皮细胞功能的影响研究[J].中国妇幼保健,2015,30(5):2920-2922.
2 董喜英,王春霞,李录花,等.丹参注射液联合小剂量阿司匹林治疗妊娠期高血压疾病疗效观察[J].中国煤炭工业医学杂志,2014,17(8):1284-1286.
3 罗武珍,王飞,夏建松.复方丹参注射液对妊娠高血压综合征患者肾功能及妊娠结局的影响[J].中国中西医结合肾病杂志,2014,15(5):433-435.
4 张俊清,高巍.丹参注射液对妊娠高血压综合征患者氧化应激及炎性因子的影响[J].海南医学院学报,2016,22(23):2880-2882.
5 张志娟,罗珍华,彭南燕.硫酸镁联合小剂量阿司匹林治疗妊娠期高血压病的疗效观察[J].中国医院用药评价与分析,2016,16(6):749-751.
6 乐杰.妇产科学[M].第7版,北京:人民卫生出版社,2008:92-94.
7 章晓慧,刘正大,董有静.妊娠期高血压疾病预防及治疗的药物研究进展[J].实用药物与临床,2010,13(5):371-373.
8 赵莉敏.复方丹参注射液对妊娠高血压综合征患者血浆D-二聚体水平影响[J].医学理论与实践,2017,30(11):1654-1656.
9 尹巧芝,李利民,宁楠,等.寿胎丸对控制性卵巢刺激下小鼠子宫内膜容受性的影响[J].中国计划生育学杂志,2016,26(2):85-89.
10 郑雯娜,章锦曼,朱宝生.小剂量阿司匹林预防子痫前期的研究进展[J].中国妇幼保健,2015,30(3):3754-3758.
11 许文举,林艳足,庄丽,等.氯吡格雷联合阿司匹林治疗急性心肌梗死的疗效[J].广东医学,2012,33(11):1665-1666.
12 韩雅玲.冠心病阿司匹林抵抗的研究与对策[J].中国实用内科杂志,2015,35(1):3-7.
13 邢盈,王立英.丹参注射液联合黄芪注射液治疗妊娠高血压综合征临床疗效分析[J].中华中医药学刊,2008,26(9):2072-2074.
14 韩梅.丹参注射液治疗妊娠期高血压疾病疗效观察[J].中国妇幼保健,2012,27(21):3366-3367.
15 崔誉文,霍健.复方丹参注射液联合低分子肝素对早发型重度子痫前期疗效及安全性研究[J].世界中西医结合杂志,2017,12(8):1148-1151.
16 叶文娟.纤维蛋白原、血小板聚集功能、血栓弹力图联合检测在急性脑梗死患者凝血监测中的临床意义[J].中外医学研究,2016,14(28):66-67.
17 徐晓晶.凝血功能等指标的监测在骨科围手术期的临床意义[J].中国伤残医学,2016,24(21):61-62.
18 Mukai Y,Sato S.Effect of nitric oxide deficiency on tissuetype plasminogen activator expression in the umbilical cord in a pregnancy-induced hypertension rat model[J].Pregnancy Hypertension:An International Journal of Women's Cardiovas-cular Health,2012,2(1):53-58.
19 杨素霞,陈宝平,陈芳,等.不同严重程度IgA肾病患者血管内皮细胞生长因子和内皮缩血管肽-1水平的变化及意义[J].广东医学,2015,36(24):3819-3822.
20 Tuuri AL,Jauhiainen MS,Tikkanen MJ,et al.Systolic blood pressure and fatty acid-binding protein 4predict pregnancy-induced hypertension in overweight nulliparous women[J].Placenta,2014,35(10):797-801.
21 张连英,傅珂,何英杰,等.妊娠期高血压患者血管内皮细胞功能和氧化应激水平的变化[J].疑难病杂志,2014,13(8):852-854.
22 Garcia-Benavides L,Guzman-Sanchez A,Hernandez-Mo-ra FJ,et al.Total antioxidant capacity in patients with pregnancy induced hypertension:Its relation to maternal and/or perinatal complications[J].Pregnancy Hypertension:An International Journal of Women's Cardiovascular Health,2012,2(3):282-283.
2 董喜英,王春霞,李录花,等.丹参注射液联合小剂量阿司匹林治疗妊娠期高血压疾病疗效观察[J].中国煤炭工业医学杂志,2014,17(8):1284-1286.
3 罗武珍,王飞,夏建松.复方丹参注射液对妊娠高血压综合征患者肾功能及妊娠结局的影响[J].中国中西医结合肾病杂志,2014,15(5):433-435.
4 张俊清,高巍.丹参注射液对妊娠高血压综合征患者氧化应激及炎性因子的影响[J].海南医学院学报,2016,22(23):2880-2882.
5 张志娟,罗珍华,彭南燕.硫酸镁联合小剂量阿司匹林治疗妊娠期高血压病的疗效观察[J].中国医院用药评价与分析,2016,16(6):749-751.
6 乐杰.妇产科学[M].第7版,北京:人民卫生出版社,2008:92-94.
7 章晓慧,刘正大,董有静.妊娠期高血压疾病预防及治疗的药物研究进展[J].实用药物与临床,2010,13(5):371-373.
8 赵莉敏.复方丹参注射液对妊娠高血压综合征患者血浆D-二聚体水平影响[J].医学理论与实践,2017,30(11):1654-1656.
9 尹巧芝,李利民,宁楠,等.寿胎丸对控制性卵巢刺激下小鼠子宫内膜容受性的影响[J].中国计划生育学杂志,2016,26(2):85-89.
10 郑雯娜,章锦曼,朱宝生.小剂量阿司匹林预防子痫前期的研究进展[J].中国妇幼保健,2015,30(3):3754-3758.
11 许文举,林艳足,庄丽,等.氯吡格雷联合阿司匹林治疗急性心肌梗死的疗效[J].广东医学,2012,33(11):1665-1666.
12 韩雅玲.冠心病阿司匹林抵抗的研究与对策[J].中国实用内科杂志,2015,35(1):3-7.
13 邢盈,王立英.丹参注射液联合黄芪注射液治疗妊娠高血压综合征临床疗效分析[J].中华中医药学刊,2008,26(9):2072-2074.
14 韩梅.丹参注射液治疗妊娠期高血压疾病疗效观察[J].中国妇幼保健,2012,27(21):3366-3367.
15 崔誉文,霍健.复方丹参注射液联合低分子肝素对早发型重度子痫前期疗效及安全性研究[J].世界中西医结合杂志,2017,12(8):1148-1151.
16 叶文娟.纤维蛋白原、血小板聚集功能、血栓弹力图联合检测在急性脑梗死患者凝血监测中的临床意义[J].中外医学研究,2016,14(28):66-67.
17 徐晓晶.凝血功能等指标的监测在骨科围手术期的临床意义[J].中国伤残医学,2016,24(21):61-62.
18 Mukai Y,Sato S.Effect of nitric oxide deficiency on tissuetype plasminogen activator expression in the umbilical cord in a pregnancy-induced hypertension rat model[J].Pregnancy Hypertension:An International Journal of Women's Cardiovas-cular Health,2012,2(1):53-58.
19 杨素霞,陈宝平,陈芳,等.不同严重程度IgA肾病患者血管内皮细胞生长因子和内皮缩血管肽-1水平的变化及意义[J].广东医学,2015,36(24):3819-3822.
20 Tuuri AL,Jauhiainen MS,Tikkanen MJ,et al.Systolic blood pressure and fatty acid-binding protein 4predict pregnancy-induced hypertension in overweight nulliparous women[J].Placenta,2014,35(10):797-801.
21 张连英,傅珂,何英杰,等.妊娠期高血压患者血管内皮细胞功能和氧化应激水平的变化[J].疑难病杂志,2014,13(8):852-854.
22 Garcia-Benavides L,Guzman-Sanchez A,Hernandez-Mo-ra FJ,et al.Total antioxidant capacity in patients with pregnancy induced hypertension:Its relation to maternal and/or perinatal complications[J].Pregnancy Hypertension:An International Journal of Women's Cardiovascular Health,2012,2(3):282-283.