拜新同联合拉贝洛尔治疗早期妊娠合并高血压的疗效及安全性

目的 比较拜新同联合拉贝洛尔和拜新同联合氢氯噻嗪治疗妊娠合并慢性高血压的疗效及安全性.方法 在门诊收集早期妊娠（1个月）合并高血压2级患者100例,随机分为拜新同/拉贝洛尔组（观察组）和拜新同/氢氯噻嗪组（对照组）,每组50例,分别观察两组降压效果和头晕、低血压、电解质紊乱等不良反应的发生情况,共观察6个月.结果 6个月后两组收缩压和舒张压均显著下降[观察组收缩压由入组时的（165±18） mmHg下降至（130±10）mmHg,舒张压从（100±12） mmHg下降至（75±16）mmHg;对照组收缩压由入组时的（160±16） mmHg下降至（134±13） mmHg,而舒张压由（106±12） mmHg下降至（80±13） mmHg）],且组间差异无统计学意义（P＞0.05）;两组治疗前后肝、肾功能无明显变化,但对照组患者的血钾显著降低,尿酸、血糖明显升高[入组时血钾浓度为（4.0±0.3）mmol/L,6个月后血钾浓度为（3.4±0.3）mmol/L;尿酸则由（337±69）mmol/L升高至（410±100） mmol/L;血糖人组时（5.0±0.3）mmol/L,治疗6个月后血糖浓度为（6.0±0.6）mmol/L]（P＜0.05）,且头晕、电解质紊乱等不良反应的发生率显著高于观察组（对照组不良反应发生率为26％,观察组不良反应发生率为4％）（P＜0.01）.结论 拜新同联合拉贝洛尔与拜新同联合氢氯噻嗪治疗早期妊娠合并高血压2级患者具有同等降压效果,但拜新同联合拉贝洛尔方案在安全性方面优于拜新同联合氢氯噻嗪方案.

Clinical efficacy and safety of Nifedipine Controlled-release Tablets combined with Labetalol in patients with early gestational hypertension

Objective To compare the effect and safety of Nifedipine Controlled-release Tablets combined with labetalol and Nifedipine Controlled-release Tablets combined with hydrochlorothiazide in patients with early gesta- tional hypertension. Methods We collected I00 patients with early gestational hypertension from the Outpatient De- partment. The patients were randomly divided into two groups and treated by Nifedipine Controlled-release Tablets com- bined with labetalol （the observation group） and Nifedipine Controlled-release Tablets combined with hydrochlorothia- zide （the control group）, with 50 patients in each group. The patients were followed up for 6 months. The clinical effect and adverse reactions （dizziness, hypotension, electrolyte disturbances） were observed. Results Six months later, the systolic and diastolic blood pressures were significantly reduced in the two groups. The systolic pressure decreased from （165±18） mmHg to （130±10） mmHg and the diastolic pressure decreased from （100±12） mmHg to （75±16） mmHg in the observation group; meanwhile, the systolic pressure decreased from （I60±16） mmHg to （134±13） mmHg and the diastol- ic pressure decreased from （106±12） mmHg to （80±13） mmHg in the control group, with no statistically significant differ- enee between the two groups （P〉0.05）. The serum potassium decreased from （4.0±0.3） mmol/L to （3.4±0.3） mmol/L; the uric acid increased from （337±69） mmol/L to （410± 100） mmol/L; the glucose increased from （5.0±0.3） mmol/L to （6.0±0.6） mmol/L, P〈0.05. The incidence of adverse reactions in the observation group was significantly less than that in control group： with 26% in the control group and 4% in the observation group. Conclusion Both Nifedipine Con- trolled-release Tablets combined with labetalol and Nifedipine Controlled-release Tablets combined with hydrochloro- thiazide could obviously reduce the blood pressure in patients with gestational hypertension, but Nifedipine Con- trolled-release Tablets combined with labetalol is safer.