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目的探讨尼卡地平治疗妊娠期高血压的临床疗效和安全性。方法选择2009年3月至2010年3月上海交通大学医学院附属仁济医院、首都医科大学附属北京妇产医院和浙江大学医学院附属妇产科医院收治的的妊娠期高血压患者62例,随机分为尼卡地平组32例和拉贝洛尔组30例。观察各组治疗前后的血压变化情况、围产儿结局和药物不良反应。结果尼卡地平组患者在用药1 h后达到目标血压,13例患者24 h后改为口服用药,7例患者需要联合降压治疗。拉贝洛尔组患者用药4 h达到目标血压,9例患者改为口服,11例患者联合降压治疗。两组降压疗效差异具有统计学意义(P<0.05)。尼卡地平组新生儿体重和胎盘重量明显高于拉贝洛尔组(P<0.05)。两组患者用药前后心率变化差异无统计学意义(P>0.05)。结论尼卡地平可有效控制血压,可改善围产儿结局。
Objective To investigate the clinical efficacy and safety of nicardipine in the treatment of gestational hypertension. Methods From March 2009 to March 2010, 62 cases of hypertensive disorder complicating pregnancy were admitted to Yanji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Beijing Maternity Hospital affiliated to Capital Medical University and Obstetrics and Gynecology Hospital affiliated to Zhejiang University School of Medicine. Randomly divided into nicardipine group 32 cases and labetalol group 30 cases. The changes of blood pressure, perinatal outcome and adverse drug reactions were observed before and after treatment. Results In the nicardipine group, the target blood pressure was reached at 1 h after treatment. Thirteen patients changed to oral medication after 24 h, and seven patients needed combined antihypertensive treatment. In the labetalol group, the target blood pressure was reached at 4 hours after treatment, 9 cases were changed to oral administration, and 11 cases were treated with antihypertensive treatment. The difference between the two groups was statistically significant (P <0.05). Neonatal body weight and placental weight in nicardipine group were significantly higher than those in labetalol group (P <0.05). There was no significant difference in heart rate between the two groups before and after treatment (P> 0.05). Conclusion Nicardipine can effectively control blood pressure and improve perinatal outcome.