目的 探討小劑量阿司匹林聯(lián)合硫酸鎂對妊娠高血壓產婦血清視黃醇結合蛋白4（RBP4）、血清Apelin水平的影響。方法 選擇2015年2月—2017年2月在蘇州明基醫(yī)院就診的86例妊娠期高血壓患者作為研究對象。按照隨機性原則將患者分為對照組和觀察組，每組各43例。對照組患者給予硫酸鎂注射液治療，首次劑量2.5~4.0 g，用25%葡萄糖注射液20 mL稀釋后，5 min內緩慢iv，之后用60 mL 25%硫酸鎂注射液加入到1 000 mL 5%葡萄糖注射液中靜脈滴注，速度為1~2 g/h，20 g/d。觀察組患者在對照組的基礎上口服小劑量阿司匹林腸溶片，50 mg/次，1次/d。兩組均治療15 d為1個療程。觀察兩組患者的臨床療效，同時比較兩組治療前后的血壓、血清RBP4和Apelin水平，統(tǒng)計兩組癥狀恢復及合并癥發(fā)生情況。結果 治療后，觀察組總有效率為95.35%，顯著高于對照組的74.42%（P<0.05）。治療后，兩組收縮壓（SBP）、舒張壓（DBP）、平均動脈壓（MAP）均顯著降低（P<0.05），且觀察組上述指標顯著低于對照組（P<0.05）。治療后，RBP4明顯降低，Apelin明顯升高，與治療前相比存在顯著差異（P<0.05）；且觀察組與對照組相比存在顯著差異（P<0.05）。治療后，觀察組蛋白尿、水腫、高血壓恢復正常患者比例顯著高于對照組（P<0.05），其合并癥包括心臟病、腦出血、腎功能衰竭的發(fā)生率均顯著低于對照組（P<0.05）。結論 小劑量阿司匹林聯(lián)合硫酸鎂治療妊娠高血壓相比單純應用硫酸鎂可更明顯地降低患者血壓水平，同時顯著改善血清RBP4和Apelin水平，療效顯著，值得臨床推廣應用。

Objective To investigate the effects of low-dose aspirin combined with magnesium sulfate on serum retinol binding protein 4 (RBP4) and serum Alelin levels in hypertensive pregnant women. Methods A total of 86 patients with gestational hypertension who visited Suzhou Mingji Hospital from February 2015 to February 2017 were selected as the study subjects. According to the randomness principle, the patients were divided into control group and observation group, with 43 patients in each group. Patients in the control group were given Magnesium Sulfate Injection, the first dose was 2.5-4.0 g, diluted with 25% glucose injection for 20 mL, and injected intravenously within five min. After that, 60 mL 25% Magnesium Sulfate Injection was added to 1 000 mL 5% glucose injection for intravenous drip at a rate of 1-2 g/h, 20 g/d. Patients in the observation group were po administered with low-dose of Aspirin Enteric-Coated Tablets on the basis of control group, 50 mg/time, once daily. Both groups were treated for 15 days for one course of treatment. The clinical efficacy of two groups was observed. Meanwhile, the blood pressure, serum RBP4 and Apelin levels before and after treatment were compared, and the symptom recovery and complications in two groups were counted. Results After treatment, the total effective rate of the observation group was 95.35%, which was significantly higher than 74.42% of the control group (P<0.05). After treatment, SBP, DBP, and MAP in two groups were significantly decreased (P<0.05), and the above indexes in the observation group were significantly lower than those in the control group (P<0.05). After treatment, RBP4 in two groups was significantly decreased, but Apelin was significantly increased, with significant differences compared with that before treatment (P<0.05). There were significant differences between the observation group and the control group (P<0.05). After treatment, the proportion of patients with proteinuria, edema, and hypertension returned to normal in the observation group was significantly higher than that in the control group (P<0.05), and the incidence of complications including heart disease, cerebral hemorrhage, and renal failure was significantly lower than those in the control group (P<0.05). Conclusion Compared with the application of magnesium sulfate, low-dose aspirin combined with magnesium sulfate in treatment of gestational hypertension can significantly reduce the blood pressure level of patients, and significantly improve serum RBP4 and Apelin levels, with significant efficacy, which is worthy of clinical promotion and application.

R984;R96