丹参注射液联合盐酸拉贝洛尔对早发型重度子痫前期患者妊娠结局的影响

摘要

目的 探究丹参注射液联合盐酸拉贝洛尔对早发型重度子痫前期(EOSP)患者血清组织纤溶酶原激活剂抑制物-1(PAI-1)水平及不良妊娠结局的影响.方法 随机选取2016年1月至2018年3月本院EOSP患者98例,随机数字表法分为对照组和实验组,各49例.对照组予以盐酸拉贝洛尔,实验组在对照组基础上予以丹参注射液,连续治疗1周.观察两组不良妊娠结局、新生儿体质量(NW)、胎盘质量(PW)、妊娠延长时间,对比治疗前后症状改善[24h尿蛋白定量(24hUP)、平均动脉压(MAP)、24h尿量(24 hUV)、收缩压(SBP)]、血清纤溶指标[PAI-1、组织纤溶酶原激活剂(t-PA)、D-二聚体(DD)、血细胞比容(HCT)]、内皮功能及炎症因子指标[内皮素-1(ET-1)、一氧化氮(NO)、白细胞介素-6(IL-6)、肿瘤坏死因子(TNF-α)].结果 与对照组比较,治疗后实验组24 hUP、MAP、SBP水平较低,24 hUV水平较高(均P＜ 0.05).与对照组比较,治疗后实验组血清PAI-1、DD、HCT水平较低,t-PA水平较高(均P＜ 0.05).与对照组比较,治疗后实验组NO水平较高,TNF-α、ET-1、IL-6水平较低(均P＜ 0.05).实验组妊娠延长时间长于对照组,NW、PW高于对照组(均P＜ 0.05).实验组不良妊娠结局发生率较对照组低(P＜0.05).结论 EOSP患者采用盐酸拉贝洛尔联合丹参注射液治疗,有利于缓解临床症状,调节内皮功能,减轻炎症反应及高凝状态,改善妊娠结局.%Objective To investigate the effect of salvia miltiorrhiza injection combined with labetolol hydrochloride on serum tissue plasminogen activator inhibitor-1 (PAI-1) level and adverse pregnancy outcomes in patients with early onset severe preeclampsia (EOSP).Methods From January,2016 to March,2018,98 patients with EOSP treated at our hospital were enrolled,and were divided into a control group and an experimental group using random number table method,49 cases for each group.The control group were treated with labetalol hydrochloride,and the experimental group with labetalol hydrochloride and salvia miltiorrhiza injection,for 1 week.The adverse pregnancy outcomes,neonatal weight (NW),placental weight (PW),and prolonged pregnancy were observed in both groups.The symptom improvement after treatment [24 h urine protein quantitation (24 hUP),mean arterial pressure (MAP),24 h urine volume 24 hUV),systolic blood pressure (SBP),serum fibrinolysis indicators [PAI-1,tissue plasminogen activator (t-PA),D-dimer (DD),hematocrit (HCT)],endothelial function,and inflammatory factors [endothelin-1 (ET-1),nitric oxide (NO),interleukin-6 (IL-6),tumor necrosis factor (TNF-α)] were compared.Results Compared with the control group,the levels of 24 h UP,MAP,and SBP were lower and the 24 h UV level was higher in the experimental group after the treatment (all P ＜ 0.05).Compared with the control group,the serum PAI-1,DD,and HCT levels were lower and the t-PA level was higher in the experimental group (all P ＜ 0.05).Compared with the control group,the NO level was higher and the levels of TNF-α,ET-1,and IL-6 were lower in the experimental group after treatment (all P ＜ 0.05).The prolongation of pregnancy was longer and the NW and PW were higher in the experimental group than in the control group (all P ＜ 0.05).The incidence of adverse pregnancy outcomes in the experimental group was lower than that in the control group (P ＜ 0.05).Conclusion Labetalol hydrochloride combined with salvia miltiorrhiza injection for EOSP patients is beneficial to alleviate clinical symptoms,and can regulate endothelial function,reduce inflammation and hypercoagnlability,and improve pregnancy outcomes.