摘要
目的研究低分子肝素钠联合硝苯地平治疗妊娠期高血压(HDP)的效果及对妊娠结局的影响。方法队列研究。抽取2020年1月至2021年12月郑州颐和医院收治的HDP患者96例,按随机数字表法分为对照组和研究组,每组48例。对照组采用硝苯地平治疗,研究组采用低分子肝素钠联合硝苯地平治疗。比较两组临床疗效及不良妊娠结局发生率;比较两组治疗前后血压[舒张压(DBP)、收缩压(SBP)]、血管内皮功能[内皮素-1(ET-1)、同型半胱氨酸(Hcy)]、血液流变学指标[全血低切黏度、全血高切黏度、血浆黏度(PV)]。结果研究组总有效率(95.83%,46/48)高于对照组(79.17%,38/48),P<0.05。治疗后,研究组DBP、SBP水平低于对照组(P<0.05),ET-1、Hcy水平低于对照组(P<0.05)。治疗后,研究组全血低切黏度、全血高切黏度、PV低于对照组(P<0.05)。研究组不良妊娠结局发生率(8.33%,4/48)低于对照组(27.08%,13/48),P<0.05。结论低分子肝素钠联合硝苯地平治疗HDP可提升临床疗效,降低患者血压,减少难产、早产、胎盘早剥、胎儿窘迫等不良妊娠结局的发生。
ObjectiveTo investigate the therapeutic effect of low-molecular-weight heparin sodium combined with nifedipine on hypertensive disorder of pregnancy(HDP),and to analyze its influence on the pregnancy outcome.MethodsNinety-six patients with HDP treated in Zhengzhou Yihe Hospital from January 2020 to December 2021 were selected for a cohort study.And they were divided into a control group and a study group according to random number table method,with 48 cases in each group.The control group was treated with nifedipine,and the study group was treated with low-molecular-weight heparin sodium combined with nifedipine.The curative effect and incidence of adverse reactions were compared between the two groups.The blood pressure including diastolic blood pressure(DBP)and systolic blood pressure(SBP),vascular endothelial function evaluated by endothelin-1(ET-1)and homocysteine(Hcy),hemorheological indices including whole blood viscosity at low shear and high shear,and plasma viscosity(PV)were compared between the two groups before and after treatment.ResultsThe total effective rate of the study group(95.83%,46/48)was higher than that of the control group(79.17%,38/48),P<0.05.After treatment,the study group had lower level of DBP,SBP,ET-1 and Hcy compared with the control group(P<0.05).After treatment,the whole blood viscosity at low shear,whole blood viscosity at high shear and PV in the study group were lower than those in the control group(P<0.05).The incidence of poor pregnancy outcome in the study group(8.33%,4/48)was lower than that in the control group(27.08%,13/48),with significant difference(P<0.05).ConclusionsLow-molecular-weight heparin sodium combined with nifedipine in the treatment of HDP patients can improve clinical efficacy,reduce blood pressure,and decrease the occurrence of poor pregnancy outcomes,such as dystocia,premature delivery,placental abruption and fetal distress.
作者
张艳萍
王子梅
于哲
Zhang Yanping;Wang Zimei;Yu zhe(Department of Obstetrics,Zhengzhou Yihe Hospital,Zhengzhou 450000,China)
出处
《中国实用医刊》
2024年第14期109-112,共4页
Chinese Journal of Practical Medicine
关键词
妊娠期高血压
硝苯地平
低分子肝素钠
妊娠结局
Hypertension,pregnancy-induced
Nifedipine
Low-molecular-weight heparin sodium
Pregnancy outcome
