目的 探討甲基多巴片聯(lián)合烏拉地爾緩釋片治療重度子癇前期的臨床療效。方法 選取2021年5月—2024年5月衡水市第二人民醫(yī)院收治的共152例重度子癇前期患者作為研究對象，按隨機數字表法將患者分為對照組和治療組，每組各76例。對照組口服烏拉地爾緩釋片，初始劑量1片/次，1次/d，持續(xù)治療1周后調整劑量2片/次，2次/d。治療組在對照組基礎上口服甲基多巴片，1片/次，3次/d，每2天調整1次劑量，維持劑量2片/次，3次/d。2組在持續(xù)治療2周統(tǒng)計療效。對比兩組的治療效果、血壓、心率、子宮動脈血流動力學、尿蛋白和血清指標。結果 治療組的總有效率為94.74%，對照組的總有效率為82.89%，組間比較差異顯著（P＜0.05）。治療后，兩組患者的舒張壓、收縮壓、平均動脈壓、心率均顯著降低（P＜0.05），且治療組的舒張壓、收縮壓、平均動脈壓、心率較對照組更低（P＜0.05）。治療后，兩組子宮動脈的收縮期峰值流速/舒張末期流速比值（S/D）、脈動指數（PI）、阻力指數（RI）均降低（P＜0.05），且治療組子宮動脈的S/D、PI、RI低于對照組（P＜0.05）。治療后，兩組的尿蛋白、血小板反應蛋白1（TSP-1）、D-二聚體、同型半胱氨酸（Hcy）均明顯下降（P＜0.05）；治療組的尿蛋白、TSP-1、D-二聚體、Hcy均低于對照組（P＜0.05）。結論 甲基多巴片聯(lián)合烏拉地爾緩釋片可提高重度子癇前期的治療效果，改善血壓和子宮動脈血流動力學，降低血管內皮損傷。

Objective To explore the clinical efficacy of Methyldopa Tablets combined with Urapidil Sustained-release Tablets in treatment of severe preeclampsia. Methods 152 Patients with severe preeclampsia admitted to The Second People's Hospital of Hengshui from May 2021 to May 2024 were selected as the research subjects. They were divided into control group and treatment group using a random number table method, with 76 cases in each group. The control group took Urapidil Sustained-release Tablets orally, with an initial dose of 1 tablets/time, once daily. After 1 week of continuous treatment, the dose was adjusted to 2 tablets/time, twice daily. On the basis of the control group, the patients in the treatment group took Methylprednisolone Tablets orally, 1 tablets/time, 3 times daily, adjusted the dose every 2 days, and maintained the dose of 2 tablets/time, 3 times daily. Two groups completed 2 weeks of treatment to evaluate the therapeutic effect. The therapeutic effects, blood pressure, heart rate, uterine artery hemodynamics, urinary protein, and serum indicators were compared between two groups. ResultsThe total effective rate of the treatment group (94.74%) was higher than 82.89% of the control group, with significant difference between the groups (P < 0.05). After treatment, the diastolic blood pressure, systolic blood pressure, mean arterial pressure, and heart rate of the two groups were significantly reduced (P < 0.05), and the diastolic blood pressure, systolic blood pressure, mean arterial pressure, and heart rate in the treatment group was lower than those of the control group (P < 0.05). After treatment, S/D, PI, and RI of the uterine artery of the two groups were lower than those before treatment (P < 0.05), and S/D, PI, and RI of the treatment group were lower than those of the control group (P < 0.05). After treatment, the urine protein, TSP-1, D-dimer, and Hcy of the two groups were significantly decreased (P < 0.05), and the urine protein, TSP-1, D-dimer, and Hcy of the treatment group were lower than those of the control group (P < 0.05). Conclusion Methyldopa Tablets combined with Urapidil Sustained-release Tablets can improve the therapeutic effect of severe preeclampsia, further improve blood pressure and uterine artery hemodynamics, reduce endothelial damage.

R984

衡水市科技計劃項目（2019014004Z）