丹参注射液联合尼卡地平治疗妊娠期高血压的临床研究

目的探讨丹参注射液联合尼卡地平治疗妊娠期高血压的临床效果。方法选取2015年6月—2017年12月中国人民解放军第三〇二医院收治的妊娠期高血压患者78例,随机分成对照组(39例)和治疗组(39例)。对照组口服盐酸尼卡地平缓释胶囊,40 mg/次,2次/d。治疗组在对照组基础上静脉滴注丹参注射液,10～20 mL加入5%葡萄糖液500 mL,1次/d。两组均连续治疗1周。观察两组患者临床疗效,同时比较治疗前后两组患者血压水平、凝血水平、血脂水平、尿酸(UA)、同型半胱氨酸(Hcy)、胎盘生长因子(PLGF)、可溶性血管内皮生长因子受体-1(sFlt-1)和妊娠结局。结果治疗后,对照组临床有效率为74.4%,显著低于治疗组的92.3%,两组比较差异具有统计学意义(P0.05)。治疗后,两组收缩压(SBP)、舒张压(DBP)值及血清低/高密度脂蛋白胆固醇(LDL-C/HDL-C)比值显著降低(P0.05),凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)值显著升高(P0.05),且治疗组血压、凝血及血脂治疗后水平明显好于对照组(P0.05)。治疗后,两组血清UA、Hcy、sFlt-1浓度显著下降(P0.05),血清PLGF水平显著升高(P0.05),且治疗组UA、Hcy、PLGF和sFlt-1水平明显好于对照组(P0.05)。治疗后,治疗组终止妊娠时间较对照组显著延长、产后24 h出血量显著减少,新生儿体质量和1 min Apgar评分均显著增加,两组比较差异具有统计学差异(P0.05)。结论丹参注射液联合尼卡地平治疗妊娠期高血压能有效减轻患者症状,调节凝血功能和血脂代谢,保护胎盘功能,改善母婴妊娠结局。

Clinical study on Danshen Injection combined with nicardipine in treatment of gestational hypertension

Objective To investigate the clinical effect of Danshen Injection combined with nicardipine in treatment of gestational hypertension. Methods Patients (78 cases) with gestational hypertension in 302 Hospital of PLA from June 2015 to December 2017 were randomly divided into control (39 cases) and treatment (39 cases) groups. Patients in the control group were po administered with Nicardipine Hydrochloride Sustained Release Capsules, 40 mg/time, twice daily. Patients in the treatment group were iv administered with Danshen Injection on the basis of the control group, 10-20 mL added into 5% glucose injection 500 mL, once daily. Patients in two groups were treated for 1 week. After treatment, the clinical efficacy was evaluated, and the blood pressure, coagulation, blood lipid levels, UA, Hcy, PLGF, sFlt-1 and the pregnant outcomes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 74.4%, which was significantly lower than 92.3% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the SBP, DBP, and serum LDL-C/HDL-C value in two groups was significantly decreased (P<0.05), but PT and APTT value was significantly increased (P<0.05), and the blood pressure, coagulation, and blood lipid levels in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the serum UA, Hcy, and sFlt-1 concentration in two groups was significantly decreased (P<0.05), but serum PLGF content was significantly increased (P<0.05), and the UA, Hcy, PLGF, and sFlt-1 levels in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the time of pregnancy termination in the treatment group was significantly longer than those in the control group, at the same time, 24 h postpartum hemorrhage was significantly decreased, but neonatal weight and 1 min Apgar scores were significantly increased, with significant difference between two groups (P<0.05). Conclusion Danshen Injection combined with nicardipine in treatment of gestational hypertension can effectively alleviate the symptoms, regulate blood coagulation function and lipid metabolism, protect placental function and improve maternal and fetal pregnancy outcome.