硝苯地平联合拉贝洛尔治疗对子痫前期 患者 sFlt–1 及 PLGF 浓度的影响

Effect of Nifedipine Combined with Labetalol on the Concentration of SFlt–1 and PLGF in Patients with Preeclampsia

摘要:

〔摘 要〕 目的：探讨硝苯地平联合拉贝洛尔治疗对子痫前期患者可溶性 Fms 样酪氨酸激酶 –1（sFlt–1）及胎盘生 长因子（PLGF）浓度的影响。 方法：选择 2021 年 4 月至 2022 年 4 月于郑州大学第一附属医院诊治的 380 例子痫前 期患者，根据简单随机法分成观察组、对照组，各 190 例。对照组患者给予硫酸镁联合硝苯地平治疗，观察组患者在 对照组基础上联合拉贝洛尔治疗，比较两组患者治疗前、治疗 14 d 后血液 / 尿液指标〔尿肌酐（UCr）、24 h 尿蛋白 定量（24h UPQ）、血清脑利尿钠肽（BNP）、sFlt–1、PLGF〕、血压〔收缩压（SBP）、舒张压（DBP）〕、超声 检查指标〔血流阻力指数（RI）、脐动脉血流速度峰谷比（S/D）与搏动指数（PI）〕以及妊娠结局。 结果：观察组 患者治疗后 UCr、24h UPQ、血清 BNP、sFlt–1 水平、SBP、DBP、RI、PI、S/D 均低于对照组，血清 PLGF 水平高于 对照组，差异具有统计学意义（P ＜ 0.05）；观察组不良妊娠结局总发生率为 13.16 %，低于对照组的 25.26 %，差异 具有统计学意义（P ＜ 0.05）。 结论：子痫前期患者联合应用硝苯地平与拉贝洛尔，可降低 UCr 与血压水平，减轻 蛋白尿症状，改善子宫动脉血流状态，进而改善妊娠结局。

Abstract:

〔Abstract〕 Objective To investigate the effect of nifedipine combined with labetalol on the concentrations of soluble Fmslike tyrosine kinase-1 (sFlt–1) and placental growth factor (PLGF) in patients with preeclampsia. Methods 380 patients with preeclampsia who were treated in the First Affiliated Hospital of Zhengzhou University from April 2021 to April 2022 were selected, and divided them into an observation group and a control group according to simple random method, with 190 cases in each group. The control group was treated with magnesium sulfate + nifedipine, and the observation group was treated with labetalol on the basis of the control group. The blood and urine indexes [urinary creatinine (UCr), 24 h urine protein quantitation (24h UPQ), serum brain natriuretic peptide (BNP), sFlt-1, PLGF], blood pressure [systolic blood pressure (SBP), diastolic blood pressure (DBP)], ultrasound examination indicators [blood flow resistance index (RI), umbilical artery blood flow velocity peak-to-valley ratio (S/D) and pulsatility index (PI)], and pregnancy outcomes. Results After treatment, the levels of UCr, 24h UPQ, serum BNP, sFlt-1, SBP, DBP, RI, PI and S/D in the observation group were lower than those in the control group, and the level of serum PLGF was higher than that in the control group, the differences were statistically significant (P < 0.05 ); The total incidence of adverse pregnancy outcome in the observation group was 13.16 %, lower than 25.26 % in the control group, and the difference was statistically significant (P < 0.05). Conclusion Combined application of nifedipine and labetalol in patients with preeclampsia can reduce UCr and blood pressure levels, relieve proteinuria symptoms, improve uterine artery blood flow, and improve pregnancy outcomes.