目的 探讨小剂量阿司匹林联合硫酸镁对妊娠高血压产妇血清视黄醇结合蛋白4（RBP4）、血清Apelin水平的影响。方法 选择2015年2月—2017年2月在苏州明基医院就诊的86例妊娠期高血压患者作为研究对象。按照随机性原则将患者分为对照组和观察组，每组各43例。对照组患者给予硫酸镁注射液治疗，首次剂量2.5~4.0 g，用25%葡萄糖注射液20 mL稀释后，5 min内缓慢iv，之后用60 mL 25%硫酸镁注射液加入到1 000 mL 5%葡萄糖注射液中静脉滴注，速度为1~2 g/h，20 g/d。观察组患者在对照组的基础上口服小剂量阿司匹林肠溶片，50 mg/次，1次/d。两组均治疗15 d为1个疗程。观察两组患者的临床疗效，同时比较两组治疗前后的血压、血清RBP4和Apelin水平，统计两组症状恢复及合并症发生情况。结果 治疗后，观察组总有效率为95.35%，显著高于对照组的74.42%（P<0.05）。治疗后，两组收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）均显著降低（P<0.05），且观察组上述指标显著低于对照组（P<0.05）。治疗后，RBP4明显降低，Apelin明显升高，与治疗前相比存在显著差异（P<0.05）；且观察组与对照组相比存在显著差异（P<0.05）。治疗后，观察组蛋白尿、水肿、高血压恢复正常患者比例显著高于对照组（P<0.05），其合并症包括心脏病、脑出血、肾功能衰竭的发生率均显著低于对照组（P<0.05）。结论 小剂量阿司匹林联合硫酸镁治疗妊娠高血压相比单纯应用硫酸镁可更明显地降低患者血压水平，同时显著改善血清RBP4和Apelin水平，疗效显著，值得临床推广应用。

Objective To investigate the effects of low-dose aspirin combined with magnesium sulfate on serum retinol binding protein 4 (RBP4) and serum Alelin levels in hypertensive pregnant women. Methods A total of 86 patients with gestational hypertension who visited Suzhou Mingji Hospital from February 2015 to February 2017 were selected as the study subjects. According to the randomness principle, the patients were divided into control group and observation group, with 43 patients in each group. Patients in the control group were given Magnesium Sulfate Injection, the first dose was 2.5-4.0 g, diluted with 25% glucose injection for 20 mL, and injected intravenously within five min. After that, 60 mL 25% Magnesium Sulfate Injection was added to 1 000 mL 5% glucose injection for intravenous drip at a rate of 1-2 g/h, 20 g/d. Patients in the observation group were po administered with low-dose of Aspirin Enteric-Coated Tablets on the basis of control group, 50 mg/time, once daily. Both groups were treated for 15 days for one course of treatment. The clinical efficacy of two groups was observed. Meanwhile, the blood pressure, serum RBP4 and Apelin levels before and after treatment were compared, and the symptom recovery and complications in two groups were counted. Results After treatment, the total effective rate of the observation group was 95.35%, which was significantly higher than 74.42% of the control group (P<0.05). After treatment, SBP, DBP, and MAP in two groups were significantly decreased (P<0.05), and the above indexes in the observation group were significantly lower than those in the control group (P<0.05). After treatment, RBP4 in two groups was significantly decreased, but Apelin was significantly increased, with significant differences compared with that before treatment (P<0.05). There were significant differences between the observation group and the control group (P<0.05). After treatment, the proportion of patients with proteinuria, edema, and hypertension returned to normal in the observation group was significantly higher than that in the control group (P<0.05), and the incidence of complications including heart disease, cerebral hemorrhage, and renal failure was significantly lower than those in the control group (P<0.05). Conclusion Compared with the application of magnesium sulfate, low-dose aspirin combined with magnesium sulfate in treatment of gestational hypertension can significantly reduce the blood pressure level of patients, and significantly improve serum RBP4 and Apelin levels, with significant efficacy, which is worthy of clinical promotion and application.

R984;R96