钙离子拮抗剂加小剂量阿司匹林或单用阿司匹林治疗慢性高血压合并妊娠的效果研究
|
摘要
目的观察钙离子拮抗剂联合小剂量阿司匹林治疗慢性高血压合并妊娠的临床疗效。方法选取2016年2月至2017年11月妇产科就诊的慢性高血压合并妊娠患者112例,随机分为观察组与对照组,每组56例。对照组单用小剂量阿司匹林治疗,观察组基于此联合钙离子拮抗剂治疗,比较2组临床疗效。结果观察组治疗总有效率(92. 86%)显著高于对照组(75%),2组比较差异有统计学意义(P <0. 05);观察组治疗后24 h尿蛋白[(1. 38±0. 43) g]、收缩压[(114. 42±8. 68) mm Hg]、舒张压[(82. 16±3. 12) mm Hg]、动脉压[(70. 25±2. 17) mm Hg]显著低于对照组,2组比较差异有统计学意义(P <0. 05);观察组并发子癫前期率(12. 5%)、早产率(3. 57%)、剖宫产率(42. 86%)、SGA率(1. 78%)、产后出血率(3. 57%)显著低于对照组,2组比较差异有统计学意义(P <0. 05)。结论钙离子拮抗剂联合小剂量阿司匹林治疗慢性高血压合并妊娠的临床疗效显著,且能有效预防子癫发生,降低早产、剖宫产发生率,改善母婴结局。
Objective To observe the clinical efficacy of calcium antagonist combined with low-dose aspirin in treatment of chronic hypertension in pregnant women. Methods A total of 112 pregnant women with chronic hypertension who were treated in our hospital from February 2016 to November 2017 were randomly divided into observation group( n = 56)and control group( n = 56). The patients in control group were treated by small dose of aspirin,however,the patients in observation group,on the basis of control group,were treated by calcium antagonist. The therapeutic effects were observed and compared between the two groups. Results The total effective rate in observation group was 92. 86%,which was significantly higher than that( 75%) in control group( P < 0. 05). After treatment,the 24 h urine protein( 1. 38 ± 0. 43) g,systolic pressure( 114. 42 ± 8. 68) mm Hg,diastolic pressure( 82. 16 ± 3. 12) mm Hg and arterial pressure( 70. 25 ± 2. 17) mm Hg in observation group were significantly lower than those in control group( P < 0. 05),moreover,the incidence rate of preeclampsia( 12. 5%),preterm birth rate( 3. 57%),cesarean section rate( 42. 86%),SGA rate( 1. 78%) and postpartum hemorrhage rate( 3. 57%) in observation group were significantly lower than those in control group( P < 0. 05). Conclusion Calcium antagonist combined with small dose aspirin is effective in treating chronic hypertension in pregnant women,which can effectively prevent the occurrence of eclampsia,reduce the incidence of premature delivery and cesarean section,so as to improve the outcome of mother and neonate.
Objective To observe the clinical efficacy of calcium antagonist combined with low-dose aspirin in treatment of chronic hypertension in pregnant women. Methods A total of 112 pregnant women with chronic hypertension who were treated in our hospital from February 2016 to November 2017 were randomly divided into observation group( n = 56)and control group( n = 56). The patients in control group were treated by small dose of aspirin,however,the patients in observation group,on the basis of control group,were treated by calcium antagonist. The therapeutic effects were observed and compared between the two groups. Results The total effective rate in observation group was 92. 86%,which was significantly higher than that( 75%) in control group( P < 0. 05). After treatment,the 24 h urine protein( 1. 38 ± 0. 43) g,systolic pressure( 114. 42 ± 8. 68) mm Hg,diastolic pressure( 82. 16 ± 3. 12) mm Hg and arterial pressure( 70. 25 ± 2. 17) mm Hg in observation group were significantly lower than those in control group( P < 0. 05),moreover,the incidence rate of preeclampsia( 12. 5%),preterm birth rate( 3. 57%),cesarean section rate( 42. 86%),SGA rate( 1. 78%) and postpartum hemorrhage rate( 3. 57%) in observation group were significantly lower than those in control group( P < 0. 05). Conclusion Calcium antagonist combined with small dose aspirin is effective in treating chronic hypertension in pregnant women,which can effectively prevent the occurrence of eclampsia,reduce the incidence of premature delivery and cesarean section,so as to improve the outcome of mother and neonate.
引文
1刘发莲,许梅,常兵.不同年龄妊娠合并慢性高血压患者妊娠结局及新生儿预后.现代诊断与治疗,2015,26:649-650.
2司晓宁.碳酸钙配伍小剂量阿司匹林对妊娠期高血压疾病高危孕产妇血压及胎盘和血清中T-bet、GATA-3的影响.中国妇幼保健,2017,32:2347-2349.
3刘美荣.钙剂加阿司匹林综合治疗妊娠期高血压患者的临床探讨.大家健康(学术版),2015,9:142-143.
4 Orlandi RR,Kenndy DW.Revision endoscopic frontal sinus surgery.Otolaryngol.Clin North Am,2011,34:77-90.
5果崇慧,杨青,赵雪莲,等.子痫前期相关危险因素的分析,河北医药,2016,38:2465-2467.
6包玉娟,郭杰,刘春燕,等.小剂量阿司匹林联合硫酸镁治疗妊娠期高血压疾病对患者血清TNF-α、IL-6、IL-10水平的影响.临床合理用药杂志,2015,8:73-74.
7 Kew J,Rees GL,Close D.Multiplanar reconstructed computed tomography images improves depiction and understanding of the anatomy of the frontal sinus and recess.Am J Rhinol,2013,16:19-23.
8 Shelbourne KD,Brueck mann RR.Rush-pin fi Xation of supracondylar and intercondylar fractures of the femur.J Bone Joint Surg Am,2014,64:161-169.
9 Stammberger HR,Kenney DW.Paranasal sinuses:Anatomic terminology and nomenclature.Ann Oto Rhinol Laryngol,2013,167:7-16.
10徐玲.硫酸镁联合小剂量阿司匹林治疗妊娠期高血压的临床效果.北方药学,2015,12:68-69.
11 Nicolls MR,Haskins K,Flores SC.OXidant stress,immune dysregulation,and vascular function in type I diabetes.Antio Xid Redo X Signal,2012,9:879-889.
12 Gokce N,Vita JA,Mc Donnell M,et al.Effect of medical and surgical weight loss on endothelial vasomotor function in obese patients.Am JCardiol,2011,95:266-268.
13 Lteif AA,Han K,Mather KJ.Obesity,insulin resistance,and the metabolic syndrome:determinants of endothelial dys function in whites and blacks.Circulation,2013,112:32-38.
14王哲,陈媛媛,李花繁,等.钙剂联合小剂量肠溶阿司匹林治疗轻度子痫前期患者的临床疗效分析.疑难病杂志,2016,15:830-833,837.
15 Foley RN,Parfrey PS,Sarnak MJ.Epidemiology of cardiovasc-ular disease in chronic renal disease.J Am Soc Nephrol,2013,9:S16-23.
2司晓宁.碳酸钙配伍小剂量阿司匹林对妊娠期高血压疾病高危孕产妇血压及胎盘和血清中T-bet、GATA-3的影响.中国妇幼保健,2017,32:2347-2349.
3刘美荣.钙剂加阿司匹林综合治疗妊娠期高血压患者的临床探讨.大家健康(学术版),2015,9:142-143.
4 Orlandi RR,Kenndy DW.Revision endoscopic frontal sinus surgery.Otolaryngol.Clin North Am,2011,34:77-90.
5果崇慧,杨青,赵雪莲,等.子痫前期相关危险因素的分析,河北医药,2016,38:2465-2467.
6包玉娟,郭杰,刘春燕,等.小剂量阿司匹林联合硫酸镁治疗妊娠期高血压疾病对患者血清TNF-α、IL-6、IL-10水平的影响.临床合理用药杂志,2015,8:73-74.
7 Kew J,Rees GL,Close D.Multiplanar reconstructed computed tomography images improves depiction and understanding of the anatomy of the frontal sinus and recess.Am J Rhinol,2013,16:19-23.
8 Shelbourne KD,Brueck mann RR.Rush-pin fi Xation of supracondylar and intercondylar fractures of the femur.J Bone Joint Surg Am,2014,64:161-169.
9 Stammberger HR,Kenney DW.Paranasal sinuses:Anatomic terminology and nomenclature.Ann Oto Rhinol Laryngol,2013,167:7-16.
10徐玲.硫酸镁联合小剂量阿司匹林治疗妊娠期高血压的临床效果.北方药学,2015,12:68-69.
11 Nicolls MR,Haskins K,Flores SC.OXidant stress,immune dysregulation,and vascular function in type I diabetes.Antio Xid Redo X Signal,2012,9:879-889.
12 Gokce N,Vita JA,Mc Donnell M,et al.Effect of medical and surgical weight loss on endothelial vasomotor function in obese patients.Am JCardiol,2011,95:266-268.
13 Lteif AA,Han K,Mather KJ.Obesity,insulin resistance,and the metabolic syndrome:determinants of endothelial dys function in whites and blacks.Circulation,2013,112:32-38.
14王哲,陈媛媛,李花繁,等.钙剂联合小剂量肠溶阿司匹林治疗轻度子痫前期患者的临床疗效分析.疑难病杂志,2016,15:830-833,837.
15 Foley RN,Parfrey PS,Sarnak MJ.Epidemiology of cardiovasc-ular disease in chronic renal disease.J Am Soc Nephrol,2013,9:S16-23.