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目的:研究米索前列醇防治AGT基因多态性产妇产后出血的临床疗效。方法:选择具有AGT M235T基因多态性患者80例,均行剖宫产手术,按照基因型随机分为观察组40例和对照组40例,分别给予米索前列醇400μg(直肠给药)和宫体注射催产素20 U,观察产妇AGT基因多态子痫前期的发生率,用药后产后出血情况及血压变化情况。结果:①观察组及对照组中具有TT基因型产妇子痫前期发生率明显高于具有MM型及MT型产妇;②观察组产后2 h内各基因型出血量明显少于对照组,出血量比较有差异,TT型出血量比较有统计学差异;2~24 h内出血量,观察组较对照组少,但无统计学差异;③两组产妇术后血压均较前明显下降,但两组间差异无统计学意义。结论:携带有AGT基因TT型的妇女子痫前期发病危险度升高;米索前列醇用于防治子痫前期产妇产后出血方便、安全、而对围产期母儿的健康无不良影响。
Objective: To study the clinical efficacy of misoprostol in preventing and treating postpartum hemorrhage with AGT gene polymorphism. Methods: Eighty patients with AGT M235T gene polymorphism were selected. All patients underwent cesarean section were divided into observation group (40 cases) and control group (40 cases) according to their genotypes. The patients were given 400μg misoprostol (rectal administration) and Uterine injection of oxytocin 20 U, observe the incidence of maternal AGT polymorphism in preeclampsia, postpartum hemorrhage and blood pressure changes. Results: (1) The incidence of preeclampsia of TT genotypes in observation group and control group was significantly higher than that in MM and MT genotypes. (2) The bleeding volume of each genotype in observation group was less than that in control group within 2 h postpartum There was a significant difference between the two groups, but there was a statistically significant difference in the amount of TT bleeding between the two groups. The amount of bleeding within 2 to 24 hours was lower in the observation group than in the control group, but there was no significant difference. There was no significant difference between the two groups. CONCLUSION: Women with TT genotype of AGT gene have a higher risk of developing preeclampsia. Misoprostol is convenient and safe for preventing postpartum hemorrhage in preeclampsia and has no adverse effect on the health of perinatal maternal.