Clinical trial of labetalol combined with low molecular weight heparin in the treatment of patients with hypertensive disorders in pregnancy
10.13699/j.cnki.1001-6821.2023.24.005
- VernacularTitle:拉贝洛尔联合低分子肝素治疗妊娠期高血压疾病患者疗效的临床研究
- Author:
Xiao-Dan ZHU
1
;
Xiu-Juan ZHENG
;
Li-Yan YE
;
Hang-Ying WANG
Author Information
1. 金华市妇幼保健院产科,浙江金华 321000
- Keywords:
labetalol;
low molecular weight heparin;
hypertensive disorders in pregnancy;
placental growth factor;
soluble vascular endothelial growth factor receptor-1
- From:
The Chinese Journal of Clinical Pharmacology
2023;39(24):3566-3570
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the curative effect of labetalol combined with low molecular weight heparin on hypertensive disorders in pregnancy(HDP).Methods HDP patients were divided into control group and treatment group.The control group was treated with labetalol 100 mg orally,q12 h,and the treatment group was subcutaneously injected with low molecular weight heparin 4 000 U,qd,on the basis of the control group.Both groups were treated until 1 d before delivery.The systolic blood pressure(SBP),diastolic blood pressure(DBP),plasma prothrombin time(PT),thrombin time(TT),fibrinogen(Fib),D-dimer(D-D),peak systolic velocity/end diastolic velocity(S/D),24 h urinary protein(24 h-PRO),serum placental growth factor(PLGF),soluble vascular endothelial growth factor receptor-1(sFlt-1),safety evaluation and pregnancy outcomes were compared between the two groups before and after 2 weeks of treatment.Results The treatment group and the control group included 29 and 33 cases,respectively.After treatment,the total effective rates in treatment group and control group were 93.10%(27 cases/29 cases),72.73%(24 cases/33 cases),with statistical difference(P<0.05).After treatment,the S/D of treatment group and control group were 1.61±0.18 and 1.73±0.19;SBP were(102.35±8.64)and(119.47±9.90)mmHg,DBP were(80.34±4.67)and(71.24±4.29)mmHg;Fib were(3.11±0.36)and(3.87±0.39)g·L-1;D-D levels were(1.32±0.40)and(1.75±0.53)mg·L-1;PT were(13.05±0.71)and(11.92±0.89)s;TT were(18.95±1.80)and(16.83±1.94)s;24h-PROwere(1.19±0.05)and(2.35±0.07)g;serum sFlt-1 levels were(1 528.05±102.33)and(1 901.92±131.47)pg·mL-1;the serum PLGF observation indexes were(149.33±12.19)and(125.68±9.17)pg·mL-1,respectively,and there were statistically significant differences between the treatment group and the control group(all P<0.05).The incidence of fetal distress,placental abruption,premature delivery and neonatal asphyxia in treatment group and control group were 9.09%,3.03%,12.12%,6.06%and 24.14%,20.69%,31.03%,27.59%,respectively,with statistical significance(all P<0.05).The adverse drug reactions in the treatment group were headache and dizziness in 3 cases,nausea and vomiting in 1 case,insomnia in 2 cases,and the adverse drug reactions in the control group were headache and dizziness in 2 cases,nausea and vomiting in 1 case,insomnia in 1 case.The total incidence of adverse drug reactions in treatment group and control group was 20.69%and 12.12%,respectively,with no statistical significance(P>0.05).Conclusion Labetalol combined with low molecular weight heparin can effectively improve curative effect,regulate sFLt-1/PLGF signaling pathways and improve pregnancy outcomes in HDP patients.