硝酸甘油对妊高征患者血流变学、血小板聚集的影响

目的:拟用硝酸甘油(Ng)治疗妊高征(PIH),评价其对PIH患者血流变学、血小板聚集的影响。方法:选取晚期正常妊娠妇女(正常组Ⅰ组:11例),中、重度妊高征患者34例PIH组,其中单用硫酸镁(Mg)治疗Ⅱ组:11例;单用硝酸甘油(Ng)治疗Ⅲ组:11例;联合用药(Mg+Ng)治疗Ⅳ组:12例]。采用血液粘度仪在高、低切变率下测血流变学,硫酸铵沉淀法测纤维蛋白原(Fn),魏式法测血沉(ESR),常规法测红细胞压积(Hct),血小板聚集仪测血小板聚集(PAg)。结果:①血流变学:产前:PIH组较Ⅰ组全血粘度(BV),红细胞聚集指数(RE)、血浆粘度(PV)、Hct、ESR、血沉方程K值(Kesr)、Fn均增高(P<0.05)差异显著;产后各组无明显差别,Ⅲ、Ⅳ组治疗后BV、ESR、Kesr、Fn下降,差异显著(P<0.05),余下指标及Ⅱ组各指标改变不明显。②血小板聚集:产前:PIH组较Ⅰ组增高,差异显著(P<0.05),产后:各组无明显差别;Ⅲ、Ⅳ组治疗后较用前降低,差异显著(P<0.01),Ⅱ组改变不明显。结论:硝酸甘油作为NO供体治疗妊高征时,能改变血流变,抑制血小板聚集。

Effect of Ng on hemorrheology and platelet aggregation in pregnancy-induced hypertension patients

Objective: To evaluate the effects of hemorrheology and platelet aggregation of Ng in treatment on PIH. Methods: They were divided into four groups: Ⅰ Normal pregnancy (n=11); Ⅱ PIH treated only with magnesium sulfate (Mg) (n=11); Ⅲ PIH treated only with Ng (n=11); Ⅳ PIH treated with Mg+Ng (n=12). The data of PIH was investigated, such as hemorrheology with high and low stress shear, fibrinogen (Fn) with amine sulfate sedimentation, erythrocyte sedimentation ratio (ESR) in Wintrobe, hemocrit (Hcr), platelet aggregation (PAg). Results: ① The blood viscosity (BV)、plasma viscosity (PV)、aggregation index of erythrocyte (RE)、Hct、ESR、Kesr、Fn of PIH grous were significantly higher (P<0.05) in antepartum; but no difference among group Ⅰ, Ⅱ, Ⅲ, Ⅳ (P>0.05) in postpartum, group Ⅲ and Ⅳ decreased significantly after treatment than before in BV, ESR, Kesr, Fn (P<0.05). but no difference in RE. PV, Hct, so did group Ⅱ (P>05). ② PAg: PIH groups increased significantly (P<0.05) in antepartum; but no difference among group Ⅰ, Ⅱ, Ⅲ, Ⅳ (P>0.05) in postpartum, group Ⅲ and Ⅳ decreased significantly after treatment than before (P<0.01), but no difference in group Ⅱ (P>05). Conclusion: Ng can be used in treatment on PIH. It can reduce the blood viscosity, inhibit platelet aggregation.