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目的 :探讨心房尿钠肽 (ANP)与硫酸镁对妊娠高血压综合征 (PIH)患者的心功能效应。方法 :40例 PIH患者随机分为 ANP组及硫酸镁组 ,每组各 2 0例。分别给予 ANP(6 μg/ kg)或硫酸镁 (2 5 0 g/ L,2 0 ml)静滴 30 min。应用美国 Acuson18XP/ 10型彩色电脑声像仪 ,监测用药前后的心功能变化。选正常孕妇 2 0例为基础心功能对照组。结果 :与对照组比较 ,PIH组心功能参数波动范围明显增加 ,但心排出量 (CO)、心率 (HR)及总外周阻力 (TPR)均值仍明显增高 (P<0 .0 1或 P<0 .0 5 )。ANP治疗后平均动脉压 (MAP) ,HR及 TPR明显下降 (均 P<0 .0 1)。CO、心排血指数 (CI)及每搏输出量 (SV)升高或下降不一致 ,但均接近正常范围。HR,CO,CI及 SV变化值与基础参数值呈显著正相关 (P<0 .0 1或 P<0 .0 5 )。硫酸镁组 SV,CO,CI及 HR呈增高趋势 ,但差异无显著意义 (P>0 .0 5 )。MAP无明显变化 (P>0 .0 5 ) ,TPR明显下降 (P<0 .0 1)。结论 :ANP纠正 PIH患者的心功能紊乱 ,硫酸镁可能对改善 PIH患者的心功能不起重要作用。
Objective: To investigate the cardiac effects of atrial natriuretic peptide (ANP) and magnesium sulfate on patients with pregnancy induced hypertension (PIH). Methods: Forty patients with PIH were randomly divided into ANP group and magnesium sulfate group, 20 cases in each group. They were given intravenous infusion of ANP (6 μg / kg) or magnesium sulfate (250 mg / L, 20 ml) for 30 min. Application of the United States Acuson18XP / 10 color computer imager to monitor changes in cardiac function before and after treatment. Twenty normal pregnant women were selected as the basic functional group. Results: Compared with the control group, the fluctuation range of cardiac function parameters in PIH group was significantly increased, but the mean values of cardiac output (CO), heart rate (HR) and total peripheral resistance (TPR) were still significantly higher (P < 0 .0 5). Mean arterial pressure (MAP), HR and TPR decreased significantly after ANP treatment (all P <0.01). CO, cardiac output index (CI) and stroke volume (SV) increased or decreased inconsistently, but close to the normal range. The changes of HR, CO, CI and SV were positively correlated with the basic parameters (P <0.01 or P <0.05). The levels of SV, CO, CI and HR in magnesium sulfate group increased, but the difference was not significant (P> 0.05). MAP did not change significantly (P> 0.05), TPR decreased significantly (P <0.01). Conclusion: ANP corrects cardiac dysfunction in patients with PIH. Magnesium sulfate may not play an important role in improving cardiac function in PIH patients.