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[三种口服抗高血压药物治疗重度子痫前期患者的平均血压控制及其与肾功能的相关性]

[Control of blood pressure mean and its correlation with renal function in patients with severe preeclampsia treated with three oral antihypertensive agents].

作者信息

Vázquez Rodríguez Juan Gustavo

机构信息

Unidad Médica de Alta Especialidad, Hospital de Ginecología y Obstetricia número 3, Centro Médico Nacional La Raza, México, DF.

出版信息

Ginecol Obstet Mex. 2009 May;77(5):219-26.

Abstract

BACKGROUND

In severe preeclampsia, the lack of blood pressure average is a factor for adverse renal function.

OBJECTIVE

To describe the control of blood pressure mean and its correlation with the endogenous creatinine clearance in severe preeclampsia treated with three oral antihypertensive agents

PATIENTS AND METHODS

cross-sectional study on 123 pregnant women with severe preeclampsia, treated with 500 mg every 8 h methyldopa, hydralazine 50 mg every 6 h, or 100 mg of metoprolol every 12 hours from admission to the unit intensive care to the care delivery. At time of delivery were compared blood pressure average, endogenous creatinine clearance and the correlation between two of the 123 patients were divided into two groups with matching blood pressure treatment goal of < or = 95 mmHg half: group A, < or = 95 mmHg (25 cases, 20.33%) and group B, > 95 mmHg (98 cases, 79.67%). Was used to measures of central tendency and dispersion, T-test and Pearson correlation coefficient (r).

RESULTS

Blood pressure mean (mmHg) initial vs final of all patients was similar (114.64 +/- 4.54 vs 103.88 +/- 10.65, p = 1.46) but not the medial blood group A vs B (89.16 +/- 4.54 vs 107.63 +/- 8.22, p = 0.05). Endogenous creatinine clearance (mL/min/1.73 m2 SC) of the total was similar (101.88 +/- 28.48 vs 98.73 +/- 29.96, p = 0.40) in group A increased by 2.5 (p = 0.71) and decreased in group B 5.69 (p = 0.0056). R of the total income to the intensive care unit was 0.11 and the birth of 0.06, 0.0033 in groupA and -0.44 and 0.13 in group B and 0.16, respectively.

CONCLUSION

The satisfactory control of blood pressure was achieved in 20.33% of cases. The correlation between blood pressure mean and endogenous creatinine clearance was very low.

摘要

背景

在重度子痫前期中,平均血压缺乏是导致肾功能不良的一个因素。

目的

描述重度子痫前期患者使用三种口服抗高血压药物治疗时平均血压的控制情况及其与内生肌酐清除率的相关性。

患者与方法

对123例重度子痫前期孕妇进行横断面研究,从入住重症监护病房到分娩,每8小时给予500mg甲基多巴、每6小时给予50mg肼屈嗪或每12小时给予100mg美托洛尔治疗。分娩时比较平均血压、内生肌酐清除率,并将123例患者分为两组,血压治疗目标匹配为≤95mmHg:A组,≤95mmHg(25例,20.33%)和B组,>95mmHg(98例,79.67%)。采用集中趋势和离散度测量、t检验和Pearson相关系数(r)。

结果

所有患者的初始与最终平均血压(mmHg)相似(114.64±4.54 vs 103.88±10.65,p = 1.46),但A组与B组的平均血压不同(89.16±4.54 vs 107.63±8.22,p = 0.05)。总体内生肌酐清除率(mL/min/1.73 m2体表面积)相似(101.88±28.48 vs 98.73±29.96,p = 0.40),A组增加2.5(p = 0.71),B组下降5.69(p = 0.0056)。入住重症监护病房时总体的r为0.11,分娩时为0.06,A组为0.0033,B组分别为-0.44和0.13以及0.16。

结论

20.33%的病例实现了血压满意控制。平均血压与内生肌酐清除率之间的相关性非常低。

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