拉贝洛尔结合不同剂量阿司匹林对子痫前期患者氧化应激、血压及母婴结局的影响

Effects of labetalol combined with varying doses of aspirin on oxidative stress, blood pressure, and maternal-fetal outcomes in preeclampsia

摘要:

目的 探究子痫前期患者使用拉贝洛尔结合不同剂量阿司匹林治疗后的氧化应激、血压及母婴结局。方法 选取2021年12月—2023年10月西北妇女儿童医院产科收治的116例子痫前期患者为研究对象，根据阿司匹林用量分为低剂量组（38例）、中剂量组（39例）和高剂量组（39例）。3组患者采用拉贝洛尔联合阿司匹林肠溶片治疗，低、中、高剂量组阿司匹林肠溶片用量分别为25、50和100 mg/d，3组患者均治疗1周。治疗后检测氧化应激指标［血清超氧化物歧化酶（SOD）和谷胱甘肽过氧化物酶（GSH-Px）活性、血清丙二醛（MDA）、脂质过氧化物（LPO）］水平、血压［收缩压（SBP）和舒张压（DBP）］，记录并比较母婴结局。结果 中、高剂量组治疗前后血清SOD、GSH-Px、MDA及LPO的差值均大于低剂量组（P <0.05）。中、高剂量组治疗前后SBP的差值均大于低剂量组（P <0.05）；低、中、高剂量组治疗前后DBP的差值比较，差异无统计学意义（P >0.05）。低、中、高剂量组剖宫产、早产、产后出血、新生儿窒息率、新生儿死亡率比较，差异均无统计学意义（P >0.05）。结论 痫前期患者使用100 mg/d阿司匹林联合拉贝洛尔治疗可以有效改善氧化应激状态、血压和母婴结局，且具有良好的安全性。

Abstract:

Objective To investigate the effects of labetalol combined with varying doses of aspirin on oxidative stress, blood pressure, and maternal-fetal outcomes in preeclampsia.Methods A total of 116 preeclampsia patients admitted to the Northwest Women's and Children's Hospital from December 2021 to October 2023 were selected for the study. They were divided into low-dose (38 cases), medium-dose (39 cases), and high-dose (39 cases) groups based on the aspirin dosage. All groups were treated with labetalol combined with enteric-coated aspirin tablets. The dosages of enteric-coated aspirin for the low, medium, and high-dose groups were 25 mg/day, 50 mg/day, and 100 mg/day, respectively, with all groups undergoing treatment for one week. After treatment, oxidative stress indicators [serum superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities, and serum malondialdehyde (MDA) and lipid peroxides (LPO) levels], blood pressure [systolic blood pressure (SBP) and diastolic blood pressure (DBP) ], and maternal and fetal outcomes were assessed and compared.Results The pre- to post-treatment changes in serum SOD and GSH-Px activities as well as MDA and LPO levels were greater in the medium- and high-dose groups than in the low-dose group (P < 0.05). The pre- to post-treatment changes in SBP were also greater in the medium- and high-dose groups compared with the low-dose group (P < 0.05), whereas no significant differences were observed among the low-, medium-, and high-dose groups in DBP changes (P > 0.05). Comparisons of cesarean section rate, preterm birth, postpartum hemorrhage, neonatal asphyxia, and neonatal mortality among the three groups showed no significant differences (P > 0.05).Conclusion Labetalol combined with 100 mg/day aspirin effectively improves oxidative stress, blood pressure control, and maternal-fetal outcomes without compromising safety in preeclampsia.