ABSTRACT
Objective:To investigate the serum endothelial cell specific molecule-1 (ESM-1) level and its clinical significance in patients with hypertensive disorders complicating pregnancy (HDCP).Methods:Three hundred pregnant women with HDCP (HDCP group) and 300 pregnant women undergoing health check-ups (healthy control group) from January to December 2019 in Maternity and Child Health Hospital of Wenling City of Zhejiang Province were selected. In HDCP group, hypertension during pregnancy was in 94 cases, mild preeclampsia was in 131 cases, and severe preeclampsia was in 75 cases. The serum ESM-1, serum uric acid and 24-hour urine protein levels were detected. The incidences of neonatal asphyxia, fetal distress, cesarean section, polyhydramnios, premature rupture of membranes and postpartum hemorrhage in the HDCP group were recorded.Results:The serum ESM-1, serum uric acid and 24-hour urine protein in HDCP group were significantly higher than those in healthy control group: (0.42 ± 0.05) μg/L vs. (0.33 ± 0.04) μg/L, (262.34 ± 23.18) mmol/L vs. (212.37 ± 22.16) mmol/L and (0.36 ± 0.07) g vs. (0.11 ± 0.03) g, and the differences were statistical significant ( P<0.01). The correlation analysis results showed that the serum ESM-1 was positive correlation with serum uric acid and 24-hour urine protein in HDCP pregnant women ( r = 0.497 and 0.512, P<0.01). The serum ESM-1 in pregnant women with mild preeclampsia and severe preeclampsia were significantly higher than that in pregnant women with hypertension during pregnancy: (0.44 ± 0.05) and (0.51 ± 0.06) μg/L vs. (0.38 ± 0.04) μg/L, the serum ESM-1 in pregnant women with severe preeclampsia was significantly higher than that in pregnant women with mild preeclampsia, and the differences were statistical significant ( P<0.05). With the median serum ESM-1 (0.41 μg/L) as the boundary, pregnant women with HDCP were divided into high ESM-1 group (154 cases) and low ESM-1 group (146 cases). The incidences of neonatal asphyxia, fetal distress, cesarean section, polyhydramnios, premature rupture of membranes and postpartum hemorrhage in high ESM-1 group were significantly higher than those in low ESM-1 group: 14.94% (23/154) vs. 6.16% (9/146), 26.62% (41/154) vs. 9.59% (14/146), 46.10% (71/154) vs. 29.45% (43/146), 25.32% (39/154) vs. 3.42% (5/146), 23.38% (36/154) vs. 4.11% (6/146) and 20.13% (31/154) vs. 7.53% (11/146), and the differences were statistical significant ( P<0.01). Conclusions:Serum ESM-1 level is elevated in pregnant women with HDCP . Serum ESM-1 level is closely related to the severity of HDCP and pregnancy outcomes.
ABSTRACT
Objective:To investigate the effect of magnesium sulfate combined with nifedipine on coagulation function, vascular endothelial function and pregnancy outcome in patients with pregnancy induced hypertension.Methods:From January 2019 to January 2020, 142 cases of pregnancy hypertension admitted to Wenling Maternal and Child Health Hospital were divided into observation group(71 cases) and control group(71 cases) according the random digital table method.The control group was treated with magnesium sulfate injection, and the observation group was treated with nifedipine sustained-release tablets on the basis of the control group.The course of treatment in both two groups was 10 days.The therapeutic effect, blood pressure, coagulation function, endothelial function and pregnancy outcome of the two groups were compared before and after treatment.Results:The total effective rate of the observation group(92.96%) was higher than that of the control group(77.47%)(χ 2=6.762, P<0.05). The systolic blood pressure [(126.52±7.97)mmHg] and diastolic blood pressure [(76.98±3.65)mmHg] in the observation group were lower than those in the control group [(137.83±10.23)mmHg and (85.21±5.12)mmHg] ( t=7.349, 11.029, all P<0.05). After treatment, the PT[(11.81±0.34)s] and APTT[(32.62±0.47)s] in the observation group were longer than those in the control group[(12.32±0.21)s and (31.45±0.58)s], while the FIB [(3.17±0.41)g/L] was lower than that in the control group [(3.83±0.36)g/L], and the difference was statistically significant between the two groups( t=10.753, 13.206, 10.193, all P<0.05). The level of serum NO [(69.32±4.26)mg/L] in the observation group was higher than that in the control group [(60.29±6.15)mg/L], while ET-1 [(62.15±6.78)mg/L] was lower than that in the control group [(74.39±10.29)mg/L] , and the difference was statistically significant between the two groups( t=10.170, 8.370, all P<0.05). The incidence of cesarean section(36.62%), fetal respiratory distress(5.63%), postpartum hemorrhage(4.23%) and premature rupture of membranes(8.45%) in the observation group were lower than those in the control group(53.52%, 25.35%, 26.76% and 22.54%)(χ 2=4.096, 10.542, 13.770, 5.379, all P<0.05). Conclusion:Magnesium sulfate combined with nifedipine can improve the coagulation function and vascular endothelial function of patients with pregnancy induced hypertension, and reduce adverse pregnancy outcome.