目的 探討丹參川芎嗪注射液聯(lián)合硝苯地平治療子癇前期的臨床療效。方法 選取2021年6月—2022年6月保定市第二中心醫(yī)院收治的114例子癇前期患者,按隨機(jī)數(shù)字表法分為對(duì)照組和治療組,每組各57例。對(duì)照組口服硝苯地平緩釋片(Ⅰ),10 mg/次,2次/d。治療組在對(duì)照組基礎(chǔ)上靜脈滴注丹參川芎嗪注射液,每次10 mL加入250mL生理鹽水中充分稀釋后給藥,1次/d。兩組均連續(xù)治療5 d。觀察兩組的臨床療效,比較治療前后兩組24 h尿蛋白定量(24 h UTP)和血壓[收縮壓(SBP)、舒張壓(DBP)]水平,凝血功能指標(biāo)及血清妊娠相關(guān)血漿蛋白A(PAPP-A)、白細(xì)胞介素-12(IL-12)、基質(zhì)細(xì)胞衍生因子1(SDF-1)、內(nèi)皮素-1(ET-1)水平。統(tǒng)計(jì)兩組不良妊娠結(jié)局及藥物不良反應(yīng)情況。結(jié)果 治療后,治療組總有效率是94.74%,顯著高于對(duì)照組的82.46%(P<0.05)。治療后,兩組24 h UTP、SBP、DBP水平均較治療前顯著降低(P<0.05);治療后,治療組24 h UTP、SBP、DBP低于對(duì)照組(P<0.05)。治療后,兩組APTT、PT均較治療前顯著延長,而FIB、D-D水平均較治療前顯著降低(P<0.05);治療后,治療組患者APTT、PT高于對(duì)照組,FIB、D-D水平低于對(duì)照組(P<0.05)。治療后,兩組血清PAPP-A、SDF-1水平均顯著上升,血清IL-12、ET-1水平均顯著下降(P<0.05);均以治療組改善更顯著(P<0.05)。治療組剖宮產(chǎn)、產(chǎn)后出血、低體質(zhì)量?jī)旱陌l(fā)生率分別是49.12%、1.75%、3.51%,均顯著低于對(duì)照組的68.42%、14.04%、14.04%(P<0.05);治療組新生兒窘迫、窒息的發(fā)生率是1.75%、1.75%,均較對(duì)照組(7.02%、3.51%)有所降低,但兩組比較差異無統(tǒng)計(jì)學(xué)意義。治療后,治療組和對(duì)照組不良反應(yīng)發(fā)生率分別是5.26%、3.51%,兩組比較差異無統(tǒng)計(jì)學(xué)意義。結(jié)論 丹參川芎嗪注射液聯(lián)合硝苯地平治療子癇前期具有較為滿意的整體療效,能有效降低患者尿蛋白和血壓水平,糾正凝血功能異常,緩解機(jī)體炎性損傷,保護(hù)血管內(nèi)皮,改善母嬰妊娠結(jié)局,且安全性好。

Objective To explore the clinical efficacy of Danshen Chuanxiongqin Injection combined with nifedipine in treatment of preeclampsia.Methods A total of 114 cases of preeclampsia patients admitted to the Second Central Hospital of Baoding from June 2021 to June 2022 were selected and divided into control group and treatment group according to random number table, with 57 cases in each group. Patients in the control group were po administered with Nifedipine Sustained-release Tablets(Ⅰ), 10 mg/time, twice daily. Patients in the treatment group were iv administered with Danshen Chuanxiongqin Injection on the basis of the control group,added 10 mL into 250mL of normal saline and gave the medicine after full dilution, once daily. Both groups were treated continuously for 5 d. After treatment, the clinical efficacy was evaluated, the 24-hour urine proteinuria(24h UTP), blood pressure(SBP, DBP)levels, blood coagulation function indexes, and serum pregnancy-related plasma protein-A(PAPP-A), interleukin-12(IL-12), stromal cell-derived factor-1(SDF-1), endothelin-1(ET-1) levels before and after treatment were compared. The adverse pregnancy outcomes and drug side effects were statistically analyzed in the two groups.Results After treatment, the total effective rate of the treatment group was 94.74%, which was significantly higher than that of the control group(82.46%, P<0.05). After treatment, 24 h UTP, SBP,and DBP levels in two groups were significantly decreased compared with before treatment(P<0.05). After treatment, 24 h UTP,SBP, and DBP in the treatment group were lower than those in the control group(P<0.05). After treatment, APTT and PT in two groups were significantly longer than before treatment, while FIB and D-D levels were significantly decreased(P<0.05). After treatment, APTT and PT in treatment group were higher than those in control group, while FIB and D-D levels in treatment group were lower than those in control group(P<0.05). After treatment, serum levels of PAPP-A and SDF-1 were significantly increased, while serum levels of IL-12 and ET-1 were significantly decreased in two groups(P<0.05). The improvement was more significant in treatment group(P<0.05). The incidence rates of cesarean section, postpartum hemorrhage and low body weight infants in the treatment group were 49.12%, 1.75%, and 3.51%, respectively, which were significantly lower than 68.42%, 14.04%, and 14.04% in the control group(P<0.05). The incidence of neonatal distress and asphyxia in the treatment group was 1.75% and 1.75%, both of which were lower than that in the control group(7.02% and 3.51%), but there was no statistical significance between the two groups.After treatment, the incidence of adverse reactions in the treatment group and the control group was 5.26% and 3.51%, respectively,and there was no statistically significant difference between the two groups.Conclusion Danshen Chuanxiongqin Injection combined with nifedipine has satisfactory overall curative effect in treatment of preeclampsia, and can effectively reduce the levels of urinary protein and blood pressure, correct the abnormal coagulation function, relieve the inflammatory injury of the body, and can protect the vascular endothelia, which can improve the pregnancy outcome of the mother and the child with good safety.

R984

保定市科技計(jì)劃項(xiàng)目(1951ZF034)