硝苯地平联合硫酸镁治疗妊娠期高血压的临床效果研究
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摘要
目的探讨硝苯地平联合硫酸镁治疗妊娠期高血压的临床效果。方法选取2013年1月至2019年1月本院妇产科收治的妊娠高血压患者412例进行回顾性分析,以随机数字表法(RNTM)将其分成A、B、C三组,A组(141例)予以硝苯地平与硫酸镁联合治疗,B组(137例)单纯予以硝苯地平治疗,C组(134例)单纯予以硫酸镁治疗,比较三组临床疗效、不良妊娠结局及治疗前后的MAP、BUN、UA、Scr等指标。结果 (1)三组治疗前的MAP、BUN、UA和Scr相比差异不显著(P>0.05);治疗后A组MAP、BUN、UA和Scr均低于B、C组,差异显著(P<0.05),而B组的MAP、BUN、UA和Scr与C组相比差异不显著(P>0.05)。(2)A组不良妊娠结局总发生率4.96%,B组9.49%,C组10.45%,三组两两相比差异不显著(P>0.05)。(3)A组总有效率96.45%,B组88.32%,C组88.81%,A组显著高于B、C组,差异显著(P<0.05),而B组与C组相比差异不显著(P>0.05)。结论对妊娠高血压患者采用硝苯地平与硫酸镁联合治疗的效果较好,既能有效的降低不良妊娠结局发生率,也能有效的提高临床疗效,有良好的临床应用价值。
Objective To investigate the clinical effect of nifedipine combined with magnesium sulfate in the treatment of hypertensive disorder complicating pregnancy. Methods A retrospective analysis of 412 cases of pregnancy-induced hypertension patients admitted to our hospital from January 2013 to January 2019 was conducted.The random number table(RNTM) was divided into three groups: A, B, and C. Group(141 cases) were treated with nifedipine and magnesium sulfate. Group B(137 cases) were treated with nifedipine alone. Group C(134 cases) were treated with magnesium sulfate alone. The clinical efficacy and adverse pregnancy outcomes of the three groups were compared. And indicators such as MAP, BUN, UA, Scr before and after treatment. Results(1) There was no significant difference in MAP, BUN, UA and Scr between the three groups before treatment(P>0.05). After treatment, MAP, BUN,UA and Scr in group A were lower than those in group B and C, and the difference was significant(P<0.05), while the MAP, BUN, UA and Scr of group B were not significantly different from group C(P>0.05).(2) The total incidence of adverse pregnancy outcomes in group A was 4.96%, 9.49% in group B and 10.45% in group C. There was no significant difference between the three groups(P>0.05).(3) The total effective rate of group A was 96.45%, that of group B was88.32%, and that of group C was 88.81%. Group A was significantly higher than group B and C, the difference was significant(P<0.05), while the difference between group B and group C was not significant(P>0.05). Conclusion The combination of nifedipine and magnesium sulfate in patients with pregnancy-induced hypertension is effective, which can effectively reduce the incidence of adverse pregnancy outcomes, and can effectively improve the clinical efficacy,and has good clinical application value.
Objective To investigate the clinical effect of nifedipine combined with magnesium sulfate in the treatment of hypertensive disorder complicating pregnancy. Methods A retrospective analysis of 412 cases of pregnancy-induced hypertension patients admitted to our hospital from January 2013 to January 2019 was conducted.The random number table(RNTM) was divided into three groups: A, B, and C. Group(141 cases) were treated with nifedipine and magnesium sulfate. Group B(137 cases) were treated with nifedipine alone. Group C(134 cases) were treated with magnesium sulfate alone. The clinical efficacy and adverse pregnancy outcomes of the three groups were compared. And indicators such as MAP, BUN, UA, Scr before and after treatment. Results(1) There was no significant difference in MAP, BUN, UA and Scr between the three groups before treatment(P>0.05). After treatment, MAP, BUN,UA and Scr in group A were lower than those in group B and C, and the difference was significant(P<0.05), while the MAP, BUN, UA and Scr of group B were not significantly different from group C(P>0.05).(2) The total incidence of adverse pregnancy outcomes in group A was 4.96%, 9.49% in group B and 10.45% in group C. There was no significant difference between the three groups(P>0.05).(3) The total effective rate of group A was 96.45%, that of group B was88.32%, and that of group C was 88.81%. Group A was significantly higher than group B and C, the difference was significant(P<0.05), while the difference between group B and group C was not significant(P>0.05). Conclusion The combination of nifedipine and magnesium sulfate in patients with pregnancy-induced hypertension is effective, which can effectively reduce the incidence of adverse pregnancy outcomes, and can effectively improve the clinical efficacy,and has good clinical application value.
引文
[1]詹前美,陈坤,冯金.硝苯地平联合硫酸镁对妊娠期高血压患者血液流变学及凝血指标的影响[J].海南医学院学报,2017,11(5):74-76.
[2]邵博一,娄明,蒋春英.硝苯地平缓释片和硫酸镁注射液联合酚妥拉明治疗妊娠期高血压综合征的临床疗效及对妊娠结局的影响[J].实用心脑肺血管病杂志,2017,5(5):107-109.
[3]蒋红清.硫酸镁联合硝苯地平治疗妊娠期高血压疾病患者的疗效及对血流动力学、尿蛋白表达水平的影响[J].中国妇幼保健2015,22(14):1231-1234.
[4]Ukah UV,Payne B,Lee T,et al.External Validation of the fullPIERS Model for Predicting Adverse Maternal Outcomes in Pregnancy Hypertension in Low-and Middle-Income CountriesNovelty and Significance[J].Hypertension,2017,69(4):705-711.
[5]钱玮,李新平,申院生.硝苯地平联合硫酸镁治疗妊娠高血压综合征患者对肾功能损伤的影响[J].疑难病杂志,2018,13(11):323-325.
[6]李瑞娟.硝苯地平联合酚妥拉明及硫酸镁对妊娠期高血压患者血流动力学及凝血功能的影响[J].中国妇幼保健,2016,33(19):4401-4404.
[7]刘丹,洪莉,李浩.硝苯地平联合硫酸镁对妊娠高血压患者氧化应激、血液流变学、血小板活性物质指标及肾功能的影响[J].海南医学院学报,2017,32(18):25-28.
[8]Kannan S,Sequeira RP.Drugs for treating severe hypertension in pregnancy:A network meta-analysis and trial sequential analysis of randomized clinical trials[J].British Journal of Clinical Pharmacology,2018,11(22):1234-1237.
[9]戴小萍.硫酸镁联合硝苯地平缓释片治疗妊娠期高血压综合征的临床研究[J].中国临床药理学杂志,2018,34(9):12-15.
[10]鲁红艳,周莉,李娜.硝苯地平、酚妥拉明及硫酸镁三药联用对妊娠期高血压疾病患者血清CysC含量的影响[J].河北医科大学学报,2018,39(5):75-77,81.
[11]Sava RI,March KL,Pepine CJ.Hypertension in pregnancy:Taking cues from pathophysiology for clinical practice[J].Clinical Cardiology,2018,41(2):3213-3216.
[12]黄广翅,刘彬,张桂芳.尼莫地平联合硫酸镁治疗妊娠期高血压综合征的临床疗效[J].实用心脑肺血管病杂志,2017,11(6):145-147.
[13]隋珍,邵彩华.复方丹参注射液联合硫酸镁治疗妊娠期高血压疾病的疗效及对血清ET-1、NO、Hcy和v WF水平的影响[J].中国妇幼保健,2017,32(17):222-225.
[14]Liu D,Hong L,Li H,et al.Effect of nifedipine combined with Magnesium Sulfate on oxidative stress,hemorheology,platelet active substances and renal function in patients with pregnancyinduced hypertension[J].海南医科大学学报(英文版),2017,23(18):22-26.
[15]付景针,李娜,罗巧玲.硝苯地平和酚妥拉明联合硫酸镁对妊娠高血压综合征患者BNP的影响[J].河北医药,2018,40(11):112-114,118.
[16]罗巧玲,李娜,付景针.硫酸镁与缬沙坦联合应用对妊娠期高血压疾病患者肾功能的影响[J].河北医科大学学报,2018,39(5):114-117.
[17]Taneja R,Gupta GD.Development and Characterization Pulsatile Microspheres of Nifedipine for Hypertension[J].Recent Patents on Drug Delivery&Formulation,2017,11(999):12-21.
[18]乔远.拉贝洛尔联合硝苯地平治疗重症妊娠高血压的随机对照研究[J].实用药物与临床,2017,21(11):64-66.
[19]田继香,王芳,彭秋丽.硝苯地平联合硫酸镁在妊高症治疗中的应用及对患者血清同型半胱氨酸和C反应蛋白的影响[J].药物评价研究,2017,11(21):2221-2224.
[20]韩伟.硝苯地平联合硫酸镁治疗妊娠期高血压疾病安全性临床疗效探讨[J].河北医学,2014,20(2):1232-1236.
[2]邵博一,娄明,蒋春英.硝苯地平缓释片和硫酸镁注射液联合酚妥拉明治疗妊娠期高血压综合征的临床疗效及对妊娠结局的影响[J].实用心脑肺血管病杂志,2017,5(5):107-109.
[3]蒋红清.硫酸镁联合硝苯地平治疗妊娠期高血压疾病患者的疗效及对血流动力学、尿蛋白表达水平的影响[J].中国妇幼保健2015,22(14):1231-1234.
[4]Ukah UV,Payne B,Lee T,et al.External Validation of the fullPIERS Model for Predicting Adverse Maternal Outcomes in Pregnancy Hypertension in Low-and Middle-Income CountriesNovelty and Significance[J].Hypertension,2017,69(4):705-711.
[5]钱玮,李新平,申院生.硝苯地平联合硫酸镁治疗妊娠高血压综合征患者对肾功能损伤的影响[J].疑难病杂志,2018,13(11):323-325.
[6]李瑞娟.硝苯地平联合酚妥拉明及硫酸镁对妊娠期高血压患者血流动力学及凝血功能的影响[J].中国妇幼保健,2016,33(19):4401-4404.
[7]刘丹,洪莉,李浩.硝苯地平联合硫酸镁对妊娠高血压患者氧化应激、血液流变学、血小板活性物质指标及肾功能的影响[J].海南医学院学报,2017,32(18):25-28.
[8]Kannan S,Sequeira RP.Drugs for treating severe hypertension in pregnancy:A network meta-analysis and trial sequential analysis of randomized clinical trials[J].British Journal of Clinical Pharmacology,2018,11(22):1234-1237.
[9]戴小萍.硫酸镁联合硝苯地平缓释片治疗妊娠期高血压综合征的临床研究[J].中国临床药理学杂志,2018,34(9):12-15.
[10]鲁红艳,周莉,李娜.硝苯地平、酚妥拉明及硫酸镁三药联用对妊娠期高血压疾病患者血清CysC含量的影响[J].河北医科大学学报,2018,39(5):75-77,81.
[11]Sava RI,March KL,Pepine CJ.Hypertension in pregnancy:Taking cues from pathophysiology for clinical practice[J].Clinical Cardiology,2018,41(2):3213-3216.
[12]黄广翅,刘彬,张桂芳.尼莫地平联合硫酸镁治疗妊娠期高血压综合征的临床疗效[J].实用心脑肺血管病杂志,2017,11(6):145-147.
[13]隋珍,邵彩华.复方丹参注射液联合硫酸镁治疗妊娠期高血压疾病的疗效及对血清ET-1、NO、Hcy和v WF水平的影响[J].中国妇幼保健,2017,32(17):222-225.
[14]Liu D,Hong L,Li H,et al.Effect of nifedipine combined with Magnesium Sulfate on oxidative stress,hemorheology,platelet active substances and renal function in patients with pregnancyinduced hypertension[J].海南医科大学学报(英文版),2017,23(18):22-26.
[15]付景针,李娜,罗巧玲.硝苯地平和酚妥拉明联合硫酸镁对妊娠高血压综合征患者BNP的影响[J].河北医药,2018,40(11):112-114,118.
[16]罗巧玲,李娜,付景针.硫酸镁与缬沙坦联合应用对妊娠期高血压疾病患者肾功能的影响[J].河北医科大学学报,2018,39(5):114-117.
[17]Taneja R,Gupta GD.Development and Characterization Pulsatile Microspheres of Nifedipine for Hypertension[J].Recent Patents on Drug Delivery&Formulation,2017,11(999):12-21.
[18]乔远.拉贝洛尔联合硝苯地平治疗重症妊娠高血压的随机对照研究[J].实用药物与临床,2017,21(11):64-66.
[19]田继香,王芳,彭秋丽.硝苯地平联合硫酸镁在妊高症治疗中的应用及对患者血清同型半胱氨酸和C反应蛋白的影响[J].药物评价研究,2017,11(21):2221-2224.
[20]韩伟.硝苯地平联合硫酸镁治疗妊娠期高血压疾病安全性临床疗效探讨[J].河北医学,2014,20(2):1232-1236.