| BackgroundPreeclampsia(preeclampsia,PE)is an idiopathic disease during pregnancy with a high global incidence and represents a major cause of maternal and perinatal morbidity and mortality.Clinical manifestation of PE is characterized by high blood pressure,proteinuria,edema,with multiple dysfunction of organs and systems,of which kidney damage is a common pathological manifestation.Preeclampsia patients in a "chronic diffuse intravascular coagulation(Disseminated intravascular coagulation,DIC)" state or state before blood clots.Extensive microthrombus formation and increased blood viscosity lead to renal insufficiency of blood perfusion and damage to renal parenchyma,which can lead to decreased renal function.Ligustrazine is an extract of traditional Chinese medicine ligusticum chuanxiong,which has the effect of dilating peripheral blood vessels and improving blood pressure.It is widely used in the treatment of cardiovascular and cerebrovascular diseases in clinic.Besides,ligustrazine also has the effect of inhibiting platelet aggregation and improving microcirculation.Therefore,we intend to retrospectively analyze the effects of ligustrazine on blood pressure,urine protein,renal function and maternal and child outcomes in patients with preeclampsia,so as to understand the therapeutic effects of ligustrazine on preeclampsia,as well as its effects on renal function and the possible mechanism.ObjectivesThis study retrospectively analyzed the effect of ligustrazine on blood pressure,urine protein and maternal and child outcomes in patients with preeclampsia,and explored the therapeutic effect of ligustrazine on preeclampsia.Through the analysis of renal function related indicators,the effect of ligustrazine on renal function in patients with pre-eclampsia was discussed,and the possible mechanism of the effect of ligustrazine on renal function in patients with pre-eclampsia was discussed through the analysis of the effect of ligustrazine on coagulation function.MethodsPreeclampsia patients who were hospitalized in the the Department of Obstetrics of Second Hospital of Shandong University and the Department of Obstetric of Jinan Central Hospital from October,2017 to October,2018 were collected and divided into the following two groups according to different treatment schemes:1.Observation group:71 cases of preeclampsia patients who were hospitalized in the the Department of Obstetrics of Second Hospital of Shandong University.2.Control group:54 cases of preeclampsia patients hospitalized in the Department of Obstetric of Jinan Central Hospital.Treatment plan:conventional standard plan.All data were input into software SPSS 21.0 for statistics.Numerical data were tested by t-test,and categorical data were tested by ?2-test,and P<0.05 at the test level indicated that the difference was statistically significant.Results of blood pressure,urine protein,24-hour urine volume,SCr and PT were recorded before and after treatment in the two groups.The distribution of termination methods and weeks of gestation were recorded and compared between the two groups.The incidence of maternal and infant adverse outcomes were recorded and compared between the two groups.Results1.Comparison of baseline data between the two groupsThere were no statistically significant differences between the two groups in age,number of pregnancy and birth,severity of admission diagnosis,systolic blood pressure,diastolic blood pressure,qualitative urine protein,24-hour urine volume,renal function index and coagulation function index before treatment(P>0.05),and the baseline data before treatment were consistent.2.Comparison of blood pressure,urine volume,urine protein and 24-hour urine volume between the two groups before and after treatmentAfter treatment,the levels of SP,DP and urine protein in the two groups were significantly lower than before treatment(P<0.05),and the 24-hour urine volume was significantly increased(P<0.05).After treatment,SP(141.65±9.93)mmHg and DP(90.58±10.69)mmHg in the observation group were lower than those in the control group(148.22±8.5)mmHg and DP(95.33±8.08)mmHg(P<0.05),urine protein in the observation group was lower than that in the control group(P=0.011),and urine volume(2038.59±735.22)mL in the observation group was higher than that in the control group(1824.24±457.12)mL(P=0.048).3.Comparison of renal function indexes between the two groups before and after treatmentAfter treatment,the levels of urea,uric acid and cystatin-C in the two groups were significantly lower than before,and the levels of ALB were significantly higher than before(P<0.05).SCr was significantly decreased in the observation group(P<0.05),but not significantly in the control group(P>0.05).After treatment,SCr(50.88±11·13)umol/L,BUN(3.9±1.60)mmol/L,UA(350.59±81.24)umol/L,Cys-C(0.86±0.30)mg/L of observationg group were significantly decreased compared with the SCr(58.86±11.62)umol/L,BUN(4.59±0.96)mmol/L,UA(381.06±80.61)umol/L,Cys-C(1.59±0.58)mg/L of control group(P<0.05).ALB(33.16 4.18)g/L in the observation group was higher than that(30.64±5.65)g/L in the control group(P=0.007).4.Comparison of coagulation function between the two groups before and after treatmentAfter treatment,PT,APTT and TT time in the observation group were prolonged,PLT count was increased,and DDI and fib-c levels were decreased(P<0).05);In the control group,TT time was longer than before(P<0.05),and PT,APTT,PLT,fib-c and DDI were not significantly changed(P>0.05).After treatment,PT(11.11±1.42)s,thrombin activation time(29.04±4.15)s,thrombin activation time(17.68±1.6)s,partial thrombin activation time(26.22±3.41)s and thrombin activation time(16.46±1.03)s in the observation group were significantly longer than those in the control group(P<0.05).The DDI(2.38 ±2.95)mg/L and fibrinogen concentration(3.69 ±0.85)g/L in the observation group were lower than those in the control group(3.46 2.61)mg/L and fibrinogen concentration(4.37±1.92)g/L(P<0.05).Observation group of platelet count(182.21±56.3)10 ^ 9/L was the platelet count(169.43 ± 60.91)10 ^ 9/L change was not significant(P>0.05).5.Comparison of pregnancy outcomes and adverse outcomes between the two groupsThere was no significant difference in the distribution of gestational weeks and modes of pregnancy termination between the two groups(P>0.05).There was no significant difference in the incidence of adverse outcome between the two groups(P>0.05).Conclusions1.Ligustrazine combined with conventional treatment can effectively reduce blood pressure and urine protein in patients with preeclampsia compared with the conventional treatment alone.2.Ligustrazine combined with conventional treatment can effectively improve the renal function of preeclampsia patients,and ligustrazine has been found to alleviate the prethrombotic state of preeclampsia patients,indicating that ligustrazine may have a protective effect on the renal function of preeclampsia patients by improving their hypercoagulable state.3.Ligustrazine combined with conventional treatment cannot prolong the gestational week of patients with preeclampsia,nor can it effectively reduce the incidence of adverse maternal and infant outcomes. |
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