目的 探讨甲基多巴片联合乌拉地尔缓释片治疗重度子痫前期的临床疗效。方法 选取2021年5月—2024年5月衡水市第二人民医院收治的共152例重度子痫前期患者作为研究对象，按随机数字表法将患者分为对照组和治疗组，每组各76例。对照组口服乌拉地尔缓释片，初始剂量1片/次，1次/d，持续治疗1周后调整剂量2片/次，2次/d。治疗组在对照组基础上口服甲基多巴片，1片/次，3次/d，每2天调整1次剂量，维持剂量2片/次，3次/d。2组在持续治疗2周统计疗效。对比两组的治疗效果、血压、心率、子宫动脉血流动力学、尿蛋白和血清指标。结果 治疗组的总有效率为94.74%，对照组的总有效率为82.89%，组间比较差异显著（P＜0.05）。治疗后，两组患者的舒张压、收缩压、平均动脉压、心率均显著降低（P＜0.05），且治疗组的舒张压、收缩压、平均动脉压、心率较对照组更低（P＜0.05）。治疗后，两组子宫动脉的收缩期峰值流速/舒张末期流速比值（S/D）、脉动指数（PI）、阻力指数（RI）均降低（P＜0.05），且治疗组子宫动脉的S/D、PI、RI低于对照组（P＜0.05）。治疗后，两组的尿蛋白、血小板反应蛋白1（TSP-1）、D-二聚体、同型半胱氨酸（Hcy）均明显下降（P＜0.05）；治疗组的尿蛋白、TSP-1、D-二聚体、Hcy均低于对照组（P＜0.05）。结论 甲基多巴片联合乌拉地尔缓释片可提高重度子痫前期的治疗效果，改善血压和子宫动脉血流动力学，降低血管内皮损伤。

Objective To explore the clinical efficacy of Methyldopa Tablets combined with Urapidil Sustained-release Tablets in treatment of severe preeclampsia. Methods 152 Patients with severe preeclampsia admitted to The Second People's Hospital of Hengshui from May 2021 to May 2024 were selected as the research subjects. They were divided into control group and treatment group using a random number table method, with 76 cases in each group. The control group took Urapidil Sustained-release Tablets orally, with an initial dose of 1 tablets/time, once daily. After 1 week of continuous treatment, the dose was adjusted to 2 tablets/time, twice daily. On the basis of the control group, the patients in the treatment group took Methylprednisolone Tablets orally, 1 tablets/time, 3 times daily, adjusted the dose every 2 days, and maintained the dose of 2 tablets/time, 3 times daily. Two groups completed 2 weeks of treatment to evaluate the therapeutic effect. The therapeutic effects, blood pressure, heart rate, uterine artery hemodynamics, urinary protein, and serum indicators were compared between two groups. ResultsThe total effective rate of the treatment group (94.74%) was higher than 82.89% of the control group, with significant difference between the groups (P < 0.05). After treatment, the diastolic blood pressure, systolic blood pressure, mean arterial pressure, and heart rate of the two groups were significantly reduced (P < 0.05), and the diastolic blood pressure, systolic blood pressure, mean arterial pressure, and heart rate in the treatment group was lower than those of the control group (P < 0.05). After treatment, S/D, PI, and RI of the uterine artery of the two groups were lower than those before treatment (P < 0.05), and S/D, PI, and RI of the treatment group were lower than those of the control group (P < 0.05). After treatment, the urine protein, TSP-1, D-dimer, and Hcy of the two groups were significantly decreased (P < 0.05), and the urine protein, TSP-1, D-dimer, and Hcy of the treatment group were lower than those of the control group (P < 0.05). Conclusion Methyldopa Tablets combined with Urapidil Sustained-release Tablets can improve the therapeutic effect of severe preeclampsia, further improve blood pressure and uterine artery hemodynamics, reduce endothelial damage.

R984

衡水市科技计划项目（2019014004Z）