2023 年第 10 期 第 18 卷

甲基多巴或硝苯地平治疗妊娠高血压综合征的效果及对妊娠结局的影响

The effect of methyldopa or nifedipine in the treatment of pregnancy-induced hypertension syndrome and its impact on pregnancy outcomes

作者：马丽君翟独秀李祥雯

英文作者：Ma Lijun Zhai Duxiu Li Xiangwen

单位：新疆医科大学第一附属医院产科,乌鲁木齐830000

英文单位：Department of Obstetrics the First Affiliated Hospital of Xinjiang Medical University Urumqi 830000 China

关键词：妊娠高血压综合征；甲基多巴；硝苯地平；妊娠结局

英文关键词：Pregnancy-inducedhypertensionsyndrome;Methyldopa;Nifedipine;Pregnancyoutcome

• 摘要：

• 目的  观察甲基多巴或硝苯地平治疗妊娠高血压综合征的效果及对妊娠结局的影响。方法  选取2019年8月至2021年8月新疆医科大学第一附属医院妇产科接诊的120例妊娠高血压综合征患者。根据治疗方案的不同分为观察组、对照组和空白组，每组40例。观察组给予甲基多巴治疗，对照组给予硝苯地平治疗，空白组综合考虑患者状况未给予降压药物治疗，比较3组临床疗效、血压、凝血功能指标、血流动力学指标、不良妊娠结局总发生率。结果  观察组总有效率高于对照组［95.0%（38/40）比65.0%（26/40）］，差异有统计学意义（P<0.05）。治疗后观察组收缩压、舒张压均低于对照组，差异均有统计学意义［（121±6）mmHg（1 mmHg=0.133 kPa）比（139±10）mmHg、（81±5）mmHg比（90±5）mmHg］（均P＜0.05）。治疗后观察组活化部分凝血活酶时间、凝血酶时间、凝血酶原时间均长于对照组，子宫动脉阻力指数、脐血流均低于对照组，差异均有统计学意义（均P＜0.05）。观察组不良妊娠结局总发生率低于对照组和空白组［0（0/40）比17.5%（7/40）、35.0%（14/40）］，差异有统计学意义（均P＜0.05）。结论  甲基多巴可有效降低妊娠高血压综合征患者血压，改善凝血功能、血流动力学以及妊娠结局，临床效果显著。

• Objective  To observe the effect of methyldopa or nifedipine in the treatment of pregnancy-induced hypertension syndrome and its impact on pregnancy outcomes. Methods  Totally 120 patients with pregnancy-induced hypertension syndrome from Department of Obstetrics and Gynecology, the First Affiliated Hospital of Xinjiang Medical University from August 2019 to August 2021 were selected. They were divided into observation group, control group and blank group according to different treatment plans, with 40 cases in each group. The observation group was given methyldopa treatment, the control group was given nifedipine treatment, and the blank group was not treated with antihypertensive drugs after comprehensive consideration of the patients′ condition. The clinical efficacy, blood pressure, coagulation function, hemodynamics and the total incidence of adverse pregnancy outcomes were compared among the three groups. Results  The total effective rate of the observation group was higher than that of the control group［95.0%（38/40） vs 65.0%（26/40）］（P<0.05）. The systolic blood pressure and diastolic blood pressure of the observation group after treatment were lower than those of the control group［（121±6）mmHg vs （139±10）mmHg,（81±5）mmHg vs （90±5）mmHg］（both P＜0.05）. After treatment, the activated partial thromboplastin time, thrombin time, and prothrombin time of the observation group were longer than those of the control group, and the uterine artery resistance index and umbilical blood flow were lower than those of the control group(all P<0.05). The total incidence of adverse pregnancy outcomes of the observation group was lower than that of the control group and blank group ［0（0/40） vs 17.5%（7/40）, 35.0%（14/40）］（all P＜0.05）. Conclusion  Methyldopa can effectively reduce blood pressure, improve coagulation function, hemodynamics and pregnancy outcome in patients with pregnancy-induced hypertension syndrome, and the clinical effect is significant.