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目的探讨黄芪注射液联合盐酸拉贝洛尔和硫酸镁治疗妊娠高血压综合征的临床疗效。方法选取2013年9月—2015年9月在宝鸡市中心医院妇产科进行治疗的妊娠高血压综合征患者98例,按治疗方案不同分为对照组和治疗组,每组各49例。对照组静脉滴注盐酸拉贝洛尔注射液100 mg,加入5%葡萄糖溶液250 m L,1次/d;同时静脉滴注硫酸镁注射液,30 m L加入5%葡萄糖溶液500 m L,1次/d,根据血压的变化情况调节滴速。治疗组在对照组治疗基础上静脉滴注黄芪注射液,30 m L加入5%葡萄糖溶液150 m L,1次/d。两组均连续治疗10 d。观察两组的临床疗效,同时比较治疗前后两组全血黏度、血浆黏度、红细胞比容(HCT)、一氧化氮(NO)、丙二醛(MDA)、血浆内皮素-1(ET-1)、超氧化物歧化酶(SOD)的变化。比较两组平均动脉压(MAP)和24 h尿蛋白(Upro)的下降幅度,同时比较两组的母婴结局。结果治疗后,对照组和治疗组的总有效率分别为83.67%、95.92%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者全血黏度、血浆黏度、HCT、ET-1、MDA均较同组治疗前显著降低,NO、SOD均较同组治疗前显著升高,同组治疗前后差异具有统计学意义(P<0.05);且治疗组这些指标的改善程度优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗组患者Upro、MAP的下降幅度均显著优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗组胎心异常、新生儿窒息和剖宫产发生率明显低于对照组,两组比较差异具有统计学意义(P<0.05)。结论黄芪注射液联合盐酸拉贝洛尔和硫酸镁治疗妊娠高血压综合征具有较好的临床疗效,能够改善患者血管内皮功能,降低氧自由基,进而起到降压和减轻尿蛋白的作用,具有一定的临床推广应用价值。
Objective To investigate the clinical efficacy of Astragalus injection combined with labetalol hydrochloride and magnesium sulfate in the treatment of pregnancy-induced hypertension syndrome. Methods Seventy-nine patients with pregnancy-induced hypertension who were treated in the department of gynecology and obstetrics of Baoji Central Hospital from September 2013 to September 2015 were divided into control group and treatment group with 49 cases in each group. The control group received a bolus injection of 100 mg labetalol hydrochloride and 250 mL of 5% dextrose solution once per day. At the same time, magnesium sulfate injection and 30 mL of 5% glucose solution (500 mL) 1 times / d, according to changes in blood pressure regulation drip rate. The treatment group was treated with intravenous infusion of astragalus injection on the basis of the control group, 150 mL of 5% dextrose solution at 30 mL, once per day. Two groups were treated for 10 days. The clinical efficacy of the two groups was observed. The changes of whole blood viscosity, plasma viscosity, hematocrit (HCT), nitric oxide (NO), malondialdehyde (MDA), plasma endothelin- ), Superoxide dismutase (SOD) changes. The mean arterial pressure (MAP) and 24-h urinary protein (PROP) drop in both groups were compared, and the maternal and infant outcomes were compared between the two groups. Results After treatment, the total effective rates of the control group and the treatment group were 83.67% and 95.92%, respectively. There was significant difference between the two groups (P <0.05). After treatment, the whole blood viscosity, plasma viscosity, HCT, ET-1 and MDA of the two groups were significantly lower than those before treatment, and the levels of NO and SOD in the two groups were significantly higher than those in the same group before treatment (P <0.05). The improvement of these indexes in the treatment group was better than that in the control group, the difference between the two groups was statistically significant (P <0.05). The reduction of Upro and MAP in the treatment group was significantly better than that in the control group, the difference was statistically significant (P <0.05). Abnormal fetal heart rate in treatment group, neonatal asphyxia and cesarean section incidence was significantly lower than the control group, the difference between the two groups was statistically significant (P <0.05). Conclusion Astragalus injection combined with labetalol and magnesium sulfate in the treatment of pregnancy-induced hypertension syndrome has a good clinical curative effect, which can improve vascular endothelial function and reduce oxygen free radicals in patients, and then play a role in lowering blood pressure and alleviating urinary protein, Has a certain clinical application value.