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目的探究舌下含服米索前列醇片对妊娠期高血压疾病(HDCP)患者血清凝集素样氧化型低密度脂蛋白受体-1(s LOX-1)及蛋白Z(PZ)的影响。方法选取2014年2月-2016年2月收入该院的126例HDCP患者为研究对象,根据随机数字表法分为观察组和对照组各63例。对照组采用缩宫素进行治疗,观察组在对照组治疗基础上采用舌下含服米索前列醇片进行治疗。并对两组患者的第三产程时间、24 h内出血量、血压以及不良反应发生情况进行统计,同时检查并对比治疗前后血清s LOX-1及PZ水平。结果观察组患者的第三产程时间(291.53±74.46)min和产后出血量(7.83±2.57)ml均小于对照组[(439.54±54.75)min,(12.54±3.64)ml],差异有统计学意义(t=5.534、6.274,均P<0.05);治疗前两组患者血压差异无统计学意义(均P>0.05),治疗后观察组患者收缩压(144.84±14.34)mmHg和舒张压(90.13±11.24)mmHg均显著降低并低于对照组[(154.65±14.65)mmHg,(94.66±12.53)mmHg],差异有统计学意义(t=3.535、2.957,均P<0.05);治疗前两组患者血清s LOX-1、PZ水平比较差异无统计学意义(t=0.645、0.335,均P>0.05),治疗后两组患者的血清s LOX-1水平显著低于治疗前,PZ水平显著高于治疗前,且观察组治疗后血清s LOX-1(181.64±41.65)μg/ml及PZ(1.98±0.36)mg/L水平变化程度明显大于治疗后的对照组[(219.36±57.87)μg/ml,(1.51±0.28)mg/L],差异有统计学意义(t=4.265、4.642,均P<0.05);两组患者不良反应发生情况均较轻且差异无统计学意义(χ~2=0.34,P>0.05)。结论舌下含服米索前列醇片可有效减少HDCP产妇产后出血量,缩短第三产程时间,降低产妇血压,并能降低血清s LOX-1水平和升高PZ水平,改善HDCP患者病情。
Objective To investigate the effects of sublingual misoprostol on serum leptin-like oxidized low density lipoprotein receptor-1 (sLOX-1) and protein Z (PZ) in patients with hypertensive disorder complicating pregnancy (HDCP). Methods Totally 126 HDCP patients from February 2014 to February 2016 were enrolled in this study. According to the random number table, 63 cases were divided into observation group and control group. The control group was treated with oxytocin. The observation group was treated with sublingual misoprostol tablets on the basis of the control group. The duration of the third stage of labor, blood loss within 24 h, blood pressure and the incidence of adverse reactions in the two groups were calculated. The levels of s LOX-1 and PZ in serum before and after treatment were also examined and compared. Results The duration of the third stage of labor (291.53 ± 74.46) min and postpartum hemorrhage (7.83 ± 2.57) ml in the observation group were all less than those in the control group [(439.54 ± 54.75) min, (12.54 ± 3.64) min], the difference was statistically significant (t = 5.534,6.274, P <0.05). There was no significant difference in blood pressure between the two groups before treatment (all P> 0.05). After treatment, the systolic blood pressure (144.84 ± 14.34) mmHg and diastolic blood pressure (90.13 ± 11.24) mmHg were significantly lower than those of the control group [(154.65 ± 14.65) mmHg, (94.66 ± 12.53) mmHg], the difference was statistically significant (t = 3.535,2.957, all P <0.05) Serum s LOX-1, PZ levels were not significantly different (t = 0.645,0.335, all P> 0.05), serum s LOX-1 levels were significantly lower in both groups after treatment than before treatment, PZ levels were significantly higher Before treatment, the levels of s LOX-1 (181.64 ± 41.65) μg / ml and PZ (1.98 ± 0.36) mg / L in the observation group were significantly higher than those in the control group [(219.36 ± 57.87) μg / ml (1.51 ± 0.28) mg / L], the difference was statistically significant (t = 4.265,4.642, all P <0.05). There was no significant difference in adverse reactions between the two groups (χ ~ 2 = 0.34, P> 0.05). Conclusion Sublingual misoprostol tablets can effectively reduce HDCP maternal postpartum hemorrhage, shorten the third stage of labor time, reduce maternal blood pressure, and can reduce serum s LOX-1 level and raise the level of PZ and improve the HDCP patient’s condition.