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目的观察尼莫地平联合硫酸镁治疗妊娠期高血压综合征(PIH)的临床疗效,并探讨其对血清肿瘤坏死因子α(TNF-α)、白介素12(IL-12)及C反应蛋白(CRP)水平的影响。方法选取2014年8月—2016年9月海南现代妇婴医院收治的PIH患者63例,根据建档顺序分为对照组31例和观察组32例。对照组患者予以硫酸镁治疗,观察组患者予以尼莫地平联合硫酸镁治疗。比较两组患者临床疗效,入院时及治疗72 h后血压和血清内皮素1(ET-1)、一氧化氮(NO)、TNF-α、IL-12、CRP水平,妊娠结局。结果观察组患者临床疗效优于对照组(P<0.05)。入院时两组患者收缩压、舒张压及血清ET-1、NO水平比较,差异无统计学意义(P>0.05);治疗72 h后观察组患者收缩压、舒张压及血清ET-1水平低于对照组,血清NO水平高于对照组(P<0.05)。入院时两组患者血清TNF-α、IL-12及CRP水平比较,差异无统计学意义(P>0.05);治疗72 h后观察组患者血清TNF-α、IL-12及CRP水平低于对照组(P<0.05)。观察组患者剖宫产、新生儿窒息及胎心异常发生率低于对照组(P<0.05);两组患者死胎发生率比较,差异无统计学意义(P>0.05)。结论尼莫地平联合硫酸镁治疗PIH的临床疗效确切,可有效降低血清TNF-α、IL-12、CRP水平,改善患者妊娠结局。
Objective To observe the clinical efficacy of nimodipine combined with magnesium sulfate in the treatment of pregnancy induced hypertension (PIH) and to investigate its effect on serum tumor necrosis factor α (TNF-α), interleukin 12 (IL-12) and C-reactive protein ) Level of influence. Methods 63 patients with PIH admitted to Hainan Modern Maternity and Infant Hospital from August 2014 to September 2016 were divided into control group (31 cases) and observation group (32 cases). Patients in the control group were treated with magnesium sulfate. Patients in the observation group were treated with nimodipine and magnesium sulfate. The clinical efficacy, blood pressure and serum endothelin-1 (ET-1), serum nitric oxide (NO), TNF-α, IL-12 and CRP levels and pregnancy outcome were compared between the two groups after admission. Results The clinical efficacy of the observation group was better than that of the control group (P <0.05). There were no significant differences in systolic blood pressure, diastolic blood pressure and ET-1 and NO levels between the two groups on admission (P> 0.05). After 72 hours of treatment, systolic blood pressure, diastolic blood pressure and serum ET-1 level were lower in the observation group In the control group, serum NO level was higher than that of the control group (P <0.05). The levels of serum TNF-α, IL-12 and CRP in the two groups at admission were not significantly different (P> 0.05). The levels of TNF-α, IL-12 and CRP in the observation group were lower than those in the control group Group (P <0.05). The incidence of cesarean section, neonatal asphyxia and fetal heart rate in the observation group was lower than that in the control group (P <0.05). There was no significant difference in the incidence of stillbirth between the two groups (P> 0.05). Conclusion Nimodipine combined with magnesium sulfate in the treatment of PIH is clinically effective, which can effectively reduce the levels of serum TNF-α, IL-12 and CRP and improve the pregnancy outcome.