徐少勇 姚小凤 张晓萍

【摘要】 目的：探究拉贝洛尔辅助硫酸镁治疗重症妊娠期高血压的临床疗效及对血清C反应蛋白（CRP）、同型半胱氨酸（Hcy）水平的影响。方法：选取2017年12月-2018年12月本院收治的49例重症妊娠期高血压患者，按照随机数字表法随机分为对照组（n=24）与观察组（n=25）。对照组接受单纯硫酸镁治疗，观察组接受硫酸镁联合拉贝洛尔治疗。比较两组妊娠期高血压控制效果、治疗前后血清CRP、Hcy水平及不良反应等指标。结果：治疗后，两组收缩压、舒张压、心率均明显低于治疗前（P<0.05）。治疗后，观察组收缩压、舒张压均明显低于对照组（P<0.05）。治疗后，观察组CRP、Hcy水平均明显低于对照组（P<0.05）。两组不良反应发生率比较，差异无统计学意义（P>0.05）。观察组母婴结局不良事件发生率明显低于对照组（P<0.05）。结论：拉贝洛尔辅助硫酸镁治疗重症妊娠期高血压具有较好的临床疗效，能有效控制血压，降低血清CRP、Hcy水平，并且妊娠结局优于单纯硫酸镁治疗，安全可靠。

【關键词】 拉贝洛尔; 硫酸镁; 重症妊娠期高血压; C反应蛋白; 同型半胱氨酸; 妊娠结局

【Abstract】 Objective：To explore the clinical effect of Labetalol combined with magnesium sulfate in the treatment of severe gestational hypertension and its effect on serum C-reactive protein（CRP）and homocysteine（Hcy）.Method：A total of 49 patients with severe gestational hypertension admitted to our hospital from December 2017 to December 2018 were randomly divided into control group（n=24）and observation group（n=25）according to the random number table method.The control group were treated with magnesium sulfate alone，while the observation group were treated with Labetalol combined with magnesium sulfate.The control effect of gestational hypertension，the serum CRP，Hcy level before and after treatment and adverse reactions were compared between the two groups.Result：After treatment，systolic blood pressure，diastolic blood pressure and heart rate of the two groups were significantly lower than those before treatment（P<0.05）.After treatment，the systolic and diastolic blood pressures in the observation group were significantly lower than those in the control group（P<0.05）.After treatment，the levels of CRP and Hcy in the observation group were significantly lower than those in the control group（P<0.05）.There was no significant difference in the incidence of adverse reactions between the two groups（P>0.05）.The incidence of adverse events of maternal and infant outcomes in the observation group was significantly lower than that in the control group（P<0.05）.Conclusion：Labetalol combined with magnesium sulfate in the treatment of severe gestational hypertension has good clinical efficacy.It can effectively control blood pressure，reduce serum CRP and Hcy levels，and pregnancy outcomes are better than magnesium sulfate alone treatment，safe and reliable.

【Key words】 Labetalol; Magnesium sulfate; Severe gestational hypertension; C-reactive protein;Homocysteine; Pregnancy outcome

First-authors address：Qingyuan Maternal and Child Health Hospital，Qingyuan 511500，China

doi：10.3969/j.issn.1674-4985.2019.16.035

妊娠期高血压疾病主要发生在妊娠20周以后，发病率约占孕妇的5%[1]。临床表现为高血压综合征，以高血压、蛋白尿、水肿、抽搐、昏迷为临床特点，症状轻者仅表现为血压升高，病情严重者会导致孕妇出现抽搐、昏迷，危及胎儿与孕妇的生命[2]。针对重症妊娠期高血压的临床治疗，主要以镇静、解痉、改善微循环、扩充血容量为主要措施进行治疗，能有效确保机体脏器、子宫胎盘供血量充足[3]。硫酸镁作为解痉剂代表药物，能有效扩张血管、抑制乙酰胆碱释放起到缓解动脉痉挛，达到改善子宫胎盘血流的效果，临床上常与降压药联合使用，治疗妊娠期高血压疗效确切[4]。拉贝洛尔作为β肾上腺素受体抑制剂，特异性强，能有效降低心脏压力负荷，也是治疗妊娠期高血压的常用药物[5-6]。……