目的 探讨丹参川芎嗪注射液联合硝苯地平治疗子痫前期的临床疗效。方法 选取2021年6月—2022年6月保定市第二中心医院收治的114例子痫前期患者,按随机数字表法分为对照组和治疗组,每组各57例。对照组口服硝苯地平缓释片(Ⅰ),10 mg/次,2次/d。治疗组在对照组基础上静脉滴注丹参川芎嗪注射液,每次10 mL加入250mL生理盐水中充分稀释后给药,1次/d。两组均连续治疗5 d。观察两组的临床疗效,比较治疗前后两组24 h尿蛋白定量(24 h UTP)和血压[收缩压(SBP)、舒张压(DBP)]水平,凝血功能指标及血清妊娠相关血浆蛋白A(PAPP-A)、白细胞介素-12(IL-12)、基质细胞衍生因子1(SDF-1)、内皮素-1(ET-1)水平。统计两组不良妊娠结局及药物不良反应情况。结果 治疗后,治疗组总有效率是94.74%,显著高于对照组的82.46%(P<0.05)。治疗后,两组24 h UTP、SBP、DBP水平均较治疗前显著降低(P<0.05);治疗后,治疗组24 h UTP、SBP、DBP低于对照组(P<0.05)。治疗后,两组APTT、PT均较治疗前显著延长,而FIB、D-D水平均较治疗前显著降低(P<0.05);治疗后,治疗组患者APTT、PT高于对照组,FIB、D-D水平低于对照组(P<0.05)。治疗后,两组血清PAPP-A、SDF-1水平均显著上升,血清IL-12、ET-1水平均显著下降(P<0.05);均以治疗组改善更显著(P<0.05)。治疗组剖宫产、产后出血、低体质量儿的发生率分别是49.12%、1.75%、3.51%,均显著低于对照组的68.42%、14.04%、14.04%(P<0.05);治疗组新生儿窘迫、窒息的发生率是1.75%、1.75%,均较对照组(7.02%、3.51%)有所降低,但两组比较差异无统计学意义。治疗后,治疗组和对照组不良反应发生率分别是5.26%、3.51%,两组比较差异无统计学意义。结论 丹参川芎嗪注射液联合硝苯地平治疗子痫前期具有较为满意的整体疗效,能有效降低患者尿蛋白和血压水平,纠正凝血功能异常,缓解机体炎性损伤,保护血管内皮,改善母婴妊娠结局,且安全性好。

Objective To explore the clinical efficacy of Danshen Chuanxiongqin Injection combined with nifedipine in treatment of preeclampsia.Methods A total of 114 cases of preeclampsia patients admitted to the Second Central Hospital of Baoding from June 2021 to June 2022 were selected and divided into control group and treatment group according to random number table, with 57 cases in each group. Patients in the control group were po administered with Nifedipine Sustained-release Tablets(Ⅰ), 10 mg/time, twice daily. Patients in the treatment group were iv administered with Danshen Chuanxiongqin Injection on the basis of the control group,added 10 mL into 250mL of normal saline and gave the medicine after full dilution, once daily. Both groups were treated continuously for 5 d. After treatment, the clinical efficacy was evaluated, the 24-hour urine proteinuria(24h UTP), blood pressure(SBP, DBP)levels, blood coagulation function indexes, and serum pregnancy-related plasma protein-A(PAPP-A), interleukin-12(IL-12), stromal cell-derived factor-1(SDF-1), endothelin-1(ET-1) levels before and after treatment were compared. The adverse pregnancy outcomes and drug side effects were statistically analyzed in the two groups.Results After treatment, the total effective rate of the treatment group was 94.74%, which was significantly higher than that of the control group(82.46%, P<0.05). After treatment, 24 h UTP, SBP,and DBP levels in two groups were significantly decreased compared with before treatment(P<0.05). After treatment, 24 h UTP,SBP, and DBP in the treatment group were lower than those in the control group(P<0.05). After treatment, APTT and PT in two groups were significantly longer than before treatment, while FIB and D-D levels were significantly decreased(P<0.05). After treatment, APTT and PT in treatment group were higher than those in control group, while FIB and D-D levels in treatment group were lower than those in control group(P<0.05). After treatment, serum levels of PAPP-A and SDF-1 were significantly increased, while serum levels of IL-12 and ET-1 were significantly decreased in two groups(P<0.05). The improvement was more significant in treatment group(P<0.05). The incidence rates of cesarean section, postpartum hemorrhage and low body weight infants in the treatment group were 49.12%, 1.75%, and 3.51%, respectively, which were significantly lower than 68.42%, 14.04%, and 14.04% in the control group(P<0.05). The incidence of neonatal distress and asphyxia in the treatment group was 1.75% and 1.75%, both of which were lower than that in the control group(7.02% and 3.51%), but there was no statistical significance between the two groups.After treatment, the incidence of adverse reactions in the treatment group and the control group was 5.26% and 3.51%, respectively,and there was no statistically significant difference between the two groups.Conclusion Danshen Chuanxiongqin Injection combined with nifedipine has satisfactory overall curative effect in treatment of preeclampsia, and can effectively reduce the levels of urinary protein and blood pressure, correct the abnormal coagulation function, relieve the inflammatory injury of the body, and can protect the vascular endothelia, which can improve the pregnancy outcome of the mother and the child with good safety.

R984

保定市科技计划项目(1951ZF034)