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目的探讨硫酸镁联合硝苯地平治疗妊娠期高血压疾病患者的疗效及对血流动力学和尿蛋白水平的影响。方法126例妊娠期高血压疾病患者随机分为对照组和研究组各63例,在常规治疗的基础上对照组患者给予25%硫酸镁静脉滴注,研究组患者在对照组的基础上服用硝苯地平控释片30 mg顿服;孕周<38周者7 d为1个疗程,孕周≥38周者3 d为1个疗程,比较两组患者临床疗效以及血流动力学、尿蛋白及妊娠结局。结果研究组患者治疗总有效率93.7%显著高于对照组的81.0%,差异有统计学意义(P<0.05)。两组患者收缩压和舒张压均显著下降,组间比较差异有统计学意义(P<0.05)。两组患者全血黏度高切、中切、低切均显著下降,组间比较差异有统计学意义(P<0.05)。两组患者全血还原黏度高切、中切、低切均显著下降,组间比较差异有统计学意义(P<0.05)。两组患者24 h尿蛋白均显著下降,尿钙黏蛋白均显著下降,尿激肽原1显著下降,组间比较差异均有统计学意义(P<0.05)。研究组患者妊娠并发症总发生率14.3%显著低于对照组的30.2%,差异有统计学意义(P<0.05)。结论硫酸镁联合硝苯地平能够明显改善妊娠期高血压疾病的临床症状,改善患者的血流动力学水平,降低尿蛋白含量,改善妊娠结局。
Objective To investigate the therapeutic effect of magnesium sulfate combined with nifedipine on patients with hypertensive disorder complicating pregnancy and its effects on hemodynamics and urinary protein levels. Methods 126 cases of hypertensive disorders of pregnancy were randomly divided into control group and study group of 63 cases on the basis of conventional treatment, the control group of patients given 25% magnesium sulfate intravenous infusion, the study group patients on the basis of the control group taking nitrate Benzene terbinafine controlled release tablets 30 mg Dayton clothing; gestational weeks <38 weeks 7 days for a course of treatment, gestational age ≥ 38 weeks for 3 days for a course of treatment, the two groups were compared clinical efficacy and hemodynamics, urinary protein And pregnancy outcome. Results The total effective rate of the study group was 93.7%, which was significantly higher than that of the control group (81.0%, P <0.05). Systolic and diastolic blood pressures decreased significantly in both groups, with significant differences between the two groups (P <0.05). Two groups of patients with high blood viscosity of whole blood cut, cut, low cut significantly decreased, the difference between the two groups was statistically significant (P <0.05). The reduction of whole blood viscosity of the two groups of patients with high, medium, low cut significantly decreased, the difference between the two groups was statistically significant (P <0.05). Urinary protein in 24 hours was significantly decreased, urinary cadherin was significantly decreased in both groups, and the level of pro-urokinin 1 was significantly decreased. There was significant difference between the two groups (P <0.05). The total incidence of pregnancy complications in study group was significantly lower than that in control group (14.3% vs 30.2%, P <0.05). Conclusion Magnesium sulfate combined with nifedipine can significantly improve clinical symptoms of hypertensive disorder complicating pregnancy, improve hemodynamics, decrease urinary protein content and improve pregnancy outcome.