摘要
目的 探讨免疫抑制剂环孢素A在子痫前期中的防治及在降低炎性因子中的作用。方法回顾性选取2019年9月至2020年12月开封市妇幼保健院子痫前期高危孕妇87例,依据治疗方法分为常规治疗组(40例)、常规治疗基础上免疫抑制剂环孢素A治疗组(环孢素A组,47例)2组,统计分析2组孕妇的子痫前期发生情况、妊娠结局、新生儿结局、血压、血栓前状态分子标志物、炎性因子水平。结果 环孢素A组孕妇的子痫前期发生率低于常规治疗组(P<0.05),自觉症状改善率高于常规治疗组(P<0.05),胎盘早剥、HELLP综合征发生率均低于常规治疗组(P<0.05)。环孢素A组孕妇的胎儿平均胎龄大于常规治疗组(P<0.05),新生儿体质量高于常规治疗组(P<0.05),新生儿窒息率、新生儿死亡率均低于常规治疗组(P<0.05)。治疗后,环孢素A组孕妇的舒张压、收缩压、D-二聚体、凝血酶原活动度均低于常规治疗组(P<0.05),凝血四项包括凝血酶原时间、活化部分凝血活酶时间、凝血酶时间均长于常规治疗组(P<0.05)。治疗后,环孢素A组孕妇的血小板源性血栓素A2、环氧合酶-2、白细胞介素6、肿瘤坏死因子水平均低于常规治疗组(P<0.05)。结论 免疫抑制剂环孢素A在子痫前期中的防治及在降低炎性因子中均发挥着积极作用。
Objective To investigate the role of cyclosporine A as an immunosuppressant in prevention and treatment of preeclampsia and its active actions in reducing inflammatory factors.Methods A total of 87pregnant women at high risk of preeclampsia in Kaifeng Maternal and Children′ s Healthcare Hospital between September 2019 and December 2020 were retrospectively included.According to treatment strategy,the subjects were divided into two groups to receive conventional treatment(conventional treatment group,n =40) or conventional treatment plusthe immunosuppressant cyclosporine A(cyclosporine A group,n=47).The two groups of pregnant women were analyzed statistically for onset of preeclampsia,pregnancy outcomes,neonatal outcomes,blood pressure,molecular markers of prothrombotic status,and levels of inflammatory factors.Results Compared with the conventional treatment group,the pregnant women in cyclosporine A group experienced lower incidence of preeclampsia(P<0.05),more improvements in subjective symptoms(P<0.05),lower incidence rates of placental abruption and HELLP syndrome(P<0.05).The mean gestational age of the fetuses was longer in the pregnant women of the cyclosporine A group than in those of the conventional treatment group(P <0.05).The neonatal weight was greater in the cyclosporine A group than that in the conventional treatment group(P <0.05).The cyclosporine A group also showed less neonatal asphyxia and mortality than did the conventional treatment group(P <0.05).After treatment,the diastolic and systolic blood pressures,D-dimer(D-D) level and prothrombin time activity percentage(PTA) were lower in pregnant women of the cyclosporine A group than in those of the conventional treatment group(P<0.05).Of the 4-item coagulation test panel,the prothrombin time(PT),activated partial thromboplastin time(APTT) and thrombin time(TT) were all longer in the cyclosporine A group than those in the conventional treatment group(P<0.05).After treatment,the platelet-derived thromboxane A2(TXA2),cyclooxygenase-2(COX-2),interleukin(IL)-6,and tumor necrosis factor(TNF)-α levels were lower in the cyclosporine A group than those in the conventional treatment group(P <0.05).Conclusion The immunosuppressant cyclosporine A plays a positive role in the prevention and treatment of preeclampsia and in reducing inflammatory factors.
作者
程瑞芳
郭华娟
Cheng Ruifang;Guo Huajuan(Department of Perinatal Health,Kaifeng Maternal and Children's Healthcare Hospital,Kaifeng Key Laboratory of Reproductive Endocrinology,Henan 475002,China)
出处
《中国药物与临床》
CAS
2022年第7期596-599,共4页
Chinese Remedies & Clinics
基金
河南省开封市科技攻关项目(2003113)。
关键词
免疫抑制剂
环孢菌素
子痫
高血压
妊娠结局
Immunosuppressive agents
Cyclosporine
Eclampsia
Hypertension
Pregnancy outcome
