Discussion
Pregnancy-induced hypertension syndrome is a disease that is mainly prevented and controlled by obstetrics and gynecology department, it is one of the major causes of death of pregnant women in gestation period (11). Due to the characteristics of pregnancy-induced hypertension syndrome, such as the rapidly-developing conditions and many complications (12), once patients’ condition is not properly controlled pregnancy-induced hypertension syndrome is unceasingly aggravated, this will seriously threaten the life and safety of patients (13). A large number of clinical studies have shown that apart from the changes of indicators of blood pressure levels such as SBP and DBP, the levels of Hcy, CRP, MAP and 24 h urine protein in the peripheral blood serum of patients are closely related to the development of patients’ condition (14-16). Studies have confirmed that CRP is a sensitive indicator of inflammation and it can indicate inflammatory responses in the body (17). In recent years, many clinical studies have demonstrated that the increase of the level of Hcy and CRP may be a risk factor that leads to the occurrence of hypertension during pregnancy (17). When the expression of Hcy in the serum of pregnant women is high, it will destroy the vascular endothelial cells, lead to vasospasm and thus result in pregnancy-induced hypertension syndrome (18). However, there are few studies on the specific effects of the changes of the level of Hcy and CRP on the condition of patients with pregnancy-induced hypertension syndrome. The relationship between the changes of the level of Hcy and CRP and the clinical efficacy of related patients is still unclear. Therefore, this study investigated the effect of the combination use of magnesium sulfate and phentolamine on Hcy and CRP in the serum of patients with pregnancy-induced hypertension syndrome.
In this study, we first analyzed the changes of MAP and the content of 24 h urine protein in the patients in the observation and the control groups. We found that MAP and the content of 24 h urine protein of patients in the two groups after the treatment were significantly lower than those before the treatment. After the treatment, MAP and the content of 24 h urine protein of patients in the observation group were significantly lower than those of patients in the control group, the differences were statistically significant. A large number of clinical studies have shown that MAP and the content of 24 h urine protein are common monitoring indicators for patients with pregnancy-induced hypertension syndrome, the obvious increase of the two monitoring indicators is closely related to the development of the condition of pregnancy-induced hypertension syndrome (19). Studies related to pregnancy-induced hypertension syndrome have confirmed that the abnormal increase of MAP and the content of 24 h urine protein may aggravate the condition of patients with pregnancy-induced hypertension syndrome (20). Therefore, we believed that the combination use of magnesium sulfate and phentolamine has a better effect on the regulation of MAP and the content of 24 h urine protein in patients with pregnancy-induced hypertension syndrome. Next, we compared the changes in SBP and DBP in the patients between the observation and the control group, we found that SBP and DBP in the patients in the two groups after the treatment were significantly lower than those of patients in the two groups before the treatment. SBP and DBP in the patients in the observation group after the treatment were significantly lower than those of patients in the control group after the treatment, and the differences were statistically significant. Therefore, we believed that the combination use of magnesium sulfate and phentolamine was more effective in the down-regulation of the blood pressure level in patients with pregnancy-induced hypertension syndrome. In a previous study on the effect of magnesium sulfate combined with other drugs and the effect of the single use of magnesium sulfate on the clinical efficacy of patients with pregnancy-induced hypertension syndrome, Nzelu et al (21) found that magnesium sulfate combined with phentolamine had a better effect on the blood pressure in pregnant women in the treatment of patients with pregnancy-induc ed hypertension syndrome, which is similar to the results of our study. Then, we monitored the changes of the level of Hcy and CRP in the patients in the observation group and the control group, and found that Hcy of patients in the two groups after the treatment was significantly lower than that before the treatment, thereinto, Hcy in the patients in the observation group after the treatment was significantly lower than that of patients in the control group after the treatment, and the differences were statistically significant. Vitamin B12 is an important cofactor for the metabolism of Hcy. For those pregnant women in the middle and advanced gestation period, the amount of vitamin B12 synthesized in the body is affected by metabolism and the amount of synthesis is reduced, thus this causes the accumulation of Hcy in the body and results in the imbalance of vasomotor factors, eventually pregnancy-induced hypertension syndrome appears in pregnant women (22). CRP is an important indicator of the occurrence of inflammation, the changes of the level of CRP in the serum are closely related to the vascular endothelial injury in the body, the severity of diseases and the prognosis (23). Therefore, we speculated that the reduction range of the level of Hcy and CRP in patients with pregnancy-induced hypertension syndrome, who are treated with magnesium sulfate combined with phentolamine, is higher than that of the single use of intravenous infusion treatment of magnesium sulfate, and the clinical improvement effect is better. Finally, we compared the clinical efficacy of the patients in the two groups after the treatment, we found that the total effective rate of magnesium sulfate combined with phentolamine in the treatment of the patients with pregnancy-induced hypertension syndrome was significantly higher than that of the patients who were treated with the intravenous infusion of magnesium sulfate alone. A large number of studies on the treatment of pregnancy-induced hypertension syndrome, have verified that the efficacy of magnesium sulfate combined with phentolamine is better than that of the single use of magnesium sulfate in the treatment of patients with pregnancy-induced hypertension syndrome (24).
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In this study, there are still some shortcomings, for example, the study data can only indicate the improvement of the condition of the patients with pregnancy-induced hypertension syndrome within 3 days after the treatment, the results of the later stage still need to be clarified. This may have some impact on the results of the study; therefore, we will follow up the patients from time to time according to the relevant data of the patients in the later stage.
In summary, the meliorative effect of magnesium sulphate combined with phentolamine on the level of MAP, the content of 24 h urine protein, SBP, DBP, Hcy and CRP in pregnant woman is far more impactful than that of the single use of the intravenous infusion of magnesium sulfate in the treatment of pregnancy-induced hypertension syndrome, and the clinical efficacy of magnesium sulphate combined with phentolamine is better, thus, it is worthwhile to promote it widely in clinic.
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