佩尔地平对妊娠期高血压疾病降压效果的影响

目的:探讨佩尔地平治疗妊娠期高血压疾病的降压效果,及对妊娠结局的影响。方法:90例患者随机分为佩尔地平组、硝苯地平对照组各45例,治疗组给予佩尔地平(由日本山之内制药株式会社提供)2mg加入5%葡萄糖注射液20ml静脉缓慢推注,继以8～20mg加入5%葡萄糖注射液200ml以每分钟30～40μg的速度静脉滴注维持,根据血压调整滴速。对照组仅给予硫酸镁加硝苯地平缓释片20mg,2次/日开始,根据患者血压情况每3天增加1次剂量,最大至30mg,2次/日。观察比较两组24h后血压、心率、胎心率及对妊娠结局的影响。结果:两组治疗前收缩压、舒张压、心率水平比较差异无统计学意义(P0.05),治疗24h后,两组收缩压、舒张压水平均较治疗前下降,差异有统计学意义(P0.05);两组治疗前后心率、胎心率比较差异无统计学意义(P0.05)。治疗组平均维持妊娠时间比对照组显著延长(P0.05),且治疗组产后出血量明显少于对照组,但治疗组Apgar评分8分以上胎儿数显著高于对照组(P0.05)。结论:佩尔地平对妊娠期高血压疾病降压效果好,在迅速降压的同时能很好地控制降压的幅度,避免对胎儿造成不利影响,能达到延长孕周的目的,值得临床推广和应用。

Antihypertensive effect of perdipine on hypertensive disorder complicating pregnancy

Objective:To explore the antihypertensive effect of perdipine on hypertensive disorder complicating pregnancy (HDCP) and the effect on pregnancy outcomes.Methods:90 patients were divided into perdipine group and control group,45 patients in each group,the patients in perdipine group were treated with slow intravenous injection of 2 mg perdipine added into 20 ml 5% glucose injection,then intravenous drip of 8~20 mg perdipine added into 200 ml 5% glucose injection with a speed of 30~40 μg per minute,the speed was adjusted according to blood pressure; the patients in control group were treated with magnesium sulfate and nifedipine sustained release tablets 20 mg,twice a day,then the dose was increased every three days according to blood pressure,the maximal dose was 30 mg,twice a day; the blood pressures,heart rates,fetal heart rates and pregnancy outcomes after 24 hours were compared between the two groups.Results:Before treatment,there was no significant difference in systolic blood pressure,diastolic blood pressure and heart rate between the two groups (P>0.05); in the two groups,systolic blood pressures and diastolic blood pressures after 24 hours were significantly lower than those before treatment (P<0.05 ); there was no significant difference in heart rate and fetal heart rate in the two groups before and after treatment (P>0.05); the average time of pregnancy maintenance in treatment group was significantly longer than that in control group (P<0.05),the amount of postpartum hemorrhage in treatment group was significantly fewer than that in control group,but the number of fetus with Apgar score>8 in treatment group was significantly higher than that in control group (P<0. 05).Conclusion:The antihypertensive effect of perdipine on HDCP is good and quick,which can control the antihypertensive range,avoid the adverse effect on fetus,achieve the purpose to extend gestational age,so it is worth popularizing.