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目的探讨硝苯地平联合拉贝洛尔对重度子痫前期患者血流动力学指标、妊娠相关血浆蛋白A(PAPP-A)及血管内皮生长因子(VEGF)的影响。方法选取2013年10月-2015年10月在该院入院治疗的106例重度子痫前期患者作为研究对象,将其按照随机数字法分为对照组与观察组,每组53例。对照组患者给予硫酸镁静脉滴注,观察组患者开通两条静脉通路,一侧与对照组相同,另一侧给予拉贝洛尔静脉滴注联合硝苯地平口服,两组患者疗程均为7 d。观察并比较两组患者治疗前后的血流动力学指标、PAPP-A及VEGF水平。结果治疗前两组患者血流动力学指标比较,差异无统计学意义(P>0.05),治疗后两组患者的血液黏度、红细胞比容和脐动脉舒张压血流峰值比值(S/D)均显著下降,且观察组低于对照组(P<0.05);心脏指数显著上升,且观察组高于对照组(P<0.05)。治疗前两组患者PAPP-A、VEGF水平比较,差异无统计学意义(t_(PAPP-A)=-0.173,P>0.05;t_(VEGF)=-0.531,P>0.05),治疗后两组患者PAPP-A、VEGF水平均明显下降,且观察组低于对照组(t_(PAPP-A)=5.252,P<0.05;t_(VEGF)=7.968,P<0.05)。结论硝苯地平联合拉贝洛尔可明显改善重度子痫前期患者的血流动力学指标,降低PAPP-A、VEGF水平,临床效果显著。
Objective To investigate the effects of nifedipine combined with labetalol on hemodynamics, pregnancy-associated plasma protein A (PAPP-A) and vascular endothelial growth factor (VEGF) in patients with severe preeclampsia. Methods One hundred and sixty patients with severe preeclampsia admitted to our hospital from October 2013 to October 2015 were selected as the study subjects and divided into control group and observation group according to random number method, with 53 cases in each group. The patients in the control group were given intravenous infusion of magnesium sulfate. The patients in the observation group were given two venous access paths, the same side as the control group. The other side was given oral labetalol combined with nifedipine for oral administration. The treatment duration in both groups was 7 d. The hemodynamic parameters, PAPP-A and VEGF levels in both groups before and after treatment were observed and compared. Results There was no significant difference in hemodynamics between the two groups before treatment (P> 0.05). After treatment, blood viscosity, hematocrit and umbilical artery diastolic blood pressure peak ratio (S / D) (P <0.05). The cardiac index increased significantly, and the observation group was higher than the control group (P <0.05). There was no significant difference in the levels of PAPP-A and VEGF between the two groups before treatment (t_ (PAPP-A) = -0.1723, P> 0.05; t_ (VEGF) = -0.531, P> The levels of PAPP-A and VEGF in patients were significantly decreased, and the observation group was lower than the control group (PAPP-A = 5.252, P <0.05; t VEGFR = 7.968, P <0.05). Conclusion Nifedipine combined with labetalol can significantly improve the hemodynamic parameters of patients with severe preeclampsia, reduce PAPP-A, VEGF levels, the clinical effect was significant.