酒石酸美托洛尔联合硫酸镁治疗妊娠期高血压的效果及对患者尿液蛋白质的影响

目的 研究酒石酸美托洛尔联合硫酸镁治疗妊娠期高血压疾病的效果及对尿液蛋白质的影响。方法 选择2015年1月-2017年1月在文山州妇幼保健院诊治的妊娠期高血压患者70例，随机分为各35例的两组。对照组静脉滴注硫酸镁，每次60 mL，每10小时1次；研究组在对照组基础上口服酒石酸美托洛尔片治疗，初始剂量设定为每次20 mg，每天1次，然后每隔1天将剂量增加12.5 mg，最高剂量为每天150 mg。两组均治疗1个月。比较两组的临床有效率、新生儿结局情况（胎儿早产、胎儿窘迫、新生儿窒息和围产儿死亡），以及HPLLP综合征、产后出血、胎盘早剥等并发症的发生率以及剖宫产率，并检测两组治疗前后的尿钙黏蛋白、24 h尿蛋白以及尿激肽原1水平。结果 研究组的有效率为94.29%，明显高于对照组的80.00%，差异有统计学意义（P<0.05）。研究组的不良新生儿结局（胎儿早产、胎儿窘迫、新生儿窒息和围产儿死亡）发生率均低于对照组，差异有统计学意义（P<0.05）；研究组的并发症发生率（HPLLP综合征、产后出血、胎盘早剥）及剖宫产率均低于对照组，差异有统计学意义（P<0.05）。两组治疗后的尿钙黏蛋白、24 h尿蛋白以及尿激肽原1水平均明显降低，同组治疗前后比较差异有统计学意义（P<0.05）；且研究组明显低于对照组，差异有统计学意义（P<0.05）。结论 将酒石酸美托洛尔与硫酸镁联合用于妊娠期高血压疾病的治疗过程中，该方法临床效果显著，可有效改善母婴结局，显著降低尿液蛋白表达水平。

Effect of betoloc combined with magnesium sulfate on gestational hypertensive disorders and its influence on urine protein

Objective To investigate the clinical effect of Betoloc combined with Magnesium Sulfate on gestational hypertensive disorders and its influence on urine protein.Methods 70 cases of gestational hypertension patients who were diagnosed and treated in our hospital from January 2015 to January 2017 were randomly divided into two groups of 35 patients. The control group received intravenous Magnesium Sulfate, 60 mL each time, one time every 10 h; the study group combined with oral metoprolol treatment. Comparing the clinical efficiency of the two groups with the outcome of the newborn (fetal preterm, fetal distress, neonatal asphyxia and perinatal death), and complications of HPLLP syndrome, postpartum hemorrhage, placental abruption and the incidence of cesarean section were compaed. The levels of urinary cadherin, 24 hours urinary protein and urinary kallikrein 1 were detected before and after treatment in the two groups.Results The effective rate of the study group was 94.29% (33/35), higher than 80.00% (28/35) (P < 0.05). The incidence of adverse neonates in the study group (fetal preterm birth, fetal distress, neonatal asphyxia and perinatal death) was lower than that in the control group (P < 0.05). The incidence of complications of the study group (HPLLP syndrome, postpartum hemorrhage, placental abruption) and cesarean section rate were lower than those in the control group (P < 0.05). The levels of urinary cadherin, 24 hours urinary protein and urinary kallikrein 1 were significantly lower in the two groups (P < 0.05), and the study group was significantly lower than that of the control group (P < 0.05).Conclusion Betoloc and Magnesium Sulfate in the process of combination for the treatment of gestational hypertension disease, clinical effect is remarkable, this method can effectively improve and outcomes, and significantly reduce the urine protein expression levels.