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间苯三酚联合拉贝洛尔治疗妊娠高血压疾病的疗效研究
引用本文:袁 峰,韩 曦,王亚琴,李慧瑾,胡 盈.间苯三酚联合拉贝洛尔治疗妊娠高血压疾病的疗效研究[J].现代生物医学进展,2019,19(21):4060-4063.
作者姓名:袁 峰  韩 曦  王亚琴  李慧瑾  胡 盈
作者单位:西安交通大学第三附属医院 陕西省人民医院产科 陕西 西安 710068;西安医学院基础与转化医学研究所 陕西 西安 710021
基金项目:陕西省缺血性心血管疾病重点实验室项目(18JS103)
摘    要:目的:研究间苯三酚联合拉贝洛尔治疗妊娠高血压疾病的临床效果及可能机制。方法:选择2015年12月-2018年12月我院收治的180例妊娠高血压疾病患者,并将其根据入院的顺序,随机数字表法均分为两组,每组90例。对照组静脉滴注间苯三酚200 mg,连续给药7 d,观察组联合静脉滴注拉贝洛尔100 mg,当患者的血压降至目标期值后,将给药方法改为口服拉贝洛尔片,每次50 mg,每天3次,直至分娩前。比较两组胎盘早剥、产后出血、胎儿窘迫、剖宫产、低体重儿以及新生儿窒息的发生情况,治疗前后的收缩压(Systolic blood pressure,SBP)、平均动脉压(Mean arterial pressure,MAP)、舒张压(Diastolic blood pressure,DBP)以及血清半胱氨酸蛋白酶抑制剂C(Serum cysteine protease inhibitor C,Cys-C)、高迁移率蛋白-1(High mobility protein-1,HMGB1)、同型半胱氨酸(Homocysteine,Hcy)水平的变化。结果:治疗后,观察组的总有效率为92.22%,明显高于对照组(74.44%,P0.05);观察组的胎盘早剥率、产后出血率、胎儿窘迫发生率、剖宫产率、低体重儿率以及新生儿窒息率均明显低于对照组(P0.05);两组治疗后的SBP、MAP和、DBP、血清Hcy、HMGB1和Cys-C水平均较治疗前明显降低(P0.05),且观察组以上指标均明显低于对照组(P0.05)。结论:间苯三酚联合拉贝洛尔能显著降低妊娠高血压不良分娩结局的发生率,控制血压效果理想,其作用机制可能与降低患者血清Hcy、HMGB1和Cys-C水平有关。

关 键 词:间苯三酚  拉贝洛尔  妊娠高血压疾病  分娩结局
收稿时间:2019/3/3 0:00:00
修稿时间:2019/3/27 0:00:00

Therapeutic Effect of Phloroglucinol Combined with Labetalol on the Hypertensive Disorder Complicating Pregnancy
YUAN Feng,HAN Xi,WANG Ya-qin,LI Hui-jin,HU Ying.Therapeutic Effect of Phloroglucinol Combined with Labetalol on the Hypertensive Disorder Complicating Pregnancy[J].Progress in Modern Biomedicine,2019,19(21):4060-4063.
Authors:YUAN Feng  HAN Xi  WANG Ya-qin  LI Hui-jin  HU Ying
Institution:Department of obstetrics, The third affiliated hospital of XI''an Jiaotong university, Shaanxi provincial people''s hospital, Xi''an, Shaanxi, 710068, China;Institute of basic and translational medicine, Xi''an medical university, Xi''an, Shaanxi, 710021, China
Abstract:ABSTRACT Objective: To investigate the clinical effect of phloroglucin combined with labetalol in the treatment of pregnancy induced hypertension and its possible mechanisms. Methods: 180 cases of patients with hypertensive disorder complicating pregnancy who were treated in our hospital from December 2015 to December 2018, according to the order of admission, the random number table method is divided into two groups with 9 cases in each group. The control group was given phloroglucinol 200 mg intravenously for 7 days. The observation group was combined with intravenous drip of 100 mg of labetalol. When the patient''s blood pressure dropped to the target period, the administration method was changed to oral labetalol tablets, 50 mg each time, three times a day, until before delivery. The outcomes of delivery (placental abruption, postpartum hemorrhage, fetal distress, cesarean section, low birth weight infants and neonatal asphyxia) and the changes of ystolic blood pressure (SBP), mean arterial pressure (MAP), diastolic blood pressure (DBP), serum cysteine protease inhibitor C (Cys-C), high mobility protein-1 (HMGB1) and homocysteine (Hcy) levels before and after treatment were compared between the two groups. Results: After treatment, the total effective rate of observation group (92.22%) was significantly higher than that of the control group (74.44%, P<0.05). The rates of placental abruption, postpartum hemorrhage, fetal distress, cesarean section, low birth weight and neonatal asphyxia in the observation group were significantly lower than those in the control group (P<0.05). After treatment, the SBP, MAP and DBP of both groups were significantly decreased (P<0.05), which were more obvious decreased in the observation group (P<0.05). The levels of SBP, MAP and DBP, serum Hcy, HMGB1 and Cys-C in the two groups were significantly lower than those before treatment (P<0.05), and the above indicators in the observation group were significantly lower than the control group (P<0.05). Conclusion: The combination of phloroglucin and labetalol can significantly reduce the incidence of adverse delivery outcomes in pregnancy-induced hypertension and control blood pressure. The mechanism may be related to the reduction of serum Hcy, HMGB1 and Cys-C levels.
Keywords:Phloroglucinol  Labetalol  Hypertensive disorder complicating pregnancy  Delivery outcome
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