【摘要】 目的探讨小剂量灯盏花素治疗胎儿生长受限(FGR)的临床疗效和安全性。方法将170例FGR患者分为3组,常规治疗组42例,予能量合剂和复方氨基酸500 ml静滴;灯盏花素组77例,将灯盏花素10 mg溶于10％葡萄糖注射液500 ml中静滴,4～6 h滴完,其余治疗同常规治疗组;复方丹参组51例,将丹参16 ml加入低分子右旋糖酐500 ml中静滴,其余治疗同常规治疗组。另有47例FGR患者未行药物治疗(对照组)。治疗前后监测胎儿生长情况及脐血流变化,同时监测孕妇肝肾功能、血浆内皮素水平。记录新生儿情况并进行随访。结果(1)灯盏花素组与复方丹参组胎儿双顶径、股骨长、头围、腹围增大均优于常规治疗组和对照组(P< 0．01)。(2)灯盏花素组与复方丹参组脐动脉血流S／D值分别为2．52±0．56、2．41±0．53,均低于对照组的2．91±0．54(P<0．05)。(3)灯盏花素组新生儿出生1分钟Apgar评分8．96’±0．57’,20项神经行为评分39．21±2．45分,出生体重3．29±0．28 kg,出生身长50．42±1．69 cm,出生头围34．23±0．57 cm,均较其他三组大(P< 0．01);胎龄39．85±1．52周,也长于对照组(P(0．01)。(4)灯盏花素组足月小样儿1例(1．29％),Apgar评分<7’3例(3．89％),新生儿20项神经行为评分<36分4例(5．19％),发生率均低于对照组(P<0．01)。(5)灯盏花素组新生儿出生后42天体重5．09±0．31 kg,身长52．43±1．39 cm,头围36．27±0．66 cm,组间比较均有极显著性差异(P<0．01)。(6)各组孕妇治疗前后肝肾功能、血浆内皮素值及新生儿脐带血查心肝肾功能比较,均无显著性差异(P>0．05)。结论灯盏花素用于治疗。FGR可改善胎盘血流,使胎儿体重增加,减少足月小样儿的发生,改善围产儿的预后,且对母婴都较安全。更多还原

【Abstract】 Objective To assess the efficacy and safety of Breviscapine in management of fetal growth restriction (FGR). Methods There were 170 cases of FGR divided into study group, conventional group and control group at random. Another 47 cases just observed without therapy were in blank group. Energy-rich compound and amino acid compound 500 ml was intravenously dripped in 42 cases of the conventional group. Breviscapine 10 mg in 10% glucose liquid 500 ml was intravenously dripped in 4-6 h in 77 cases of the study group, in addition to the same therapy recipe as conventional group. Injection Dan-Shen root compound 16 mi in low molecular dextran 500 ml was intravenously dripped in 51 cases of the control group, in addition to the same therapy recipe as conventional group. The change of fetal growth and umbilical cord hemodynamics, maternal and neonatal liver and kidney function and plasma endothelin before and after therapy was recorded. The neonates were followed up. Results (1) Compared with the conventional group, the growth of fetal biparietal diameter, femur length, head circumference and abdomen circumference was better in the study group and the control group (P<0. 01) . (2) The value of umbilical artery S/D in the study group and the control group was significantly lower than that of the blank group (2. 52±0. 56, 2.41±0.53 and 2.91±0.54, respectively, P<0. 05) . (3) The neonatal Apgar score was 8. 96’±0. 57’, 20 items of neonatal behavioral neurological assessment score was 39. 21±2. 45, weight at birth was 3. 29±0. 28 kg, height at birth was 50. 42±1. 69 cm, head circumference at birth was 34. 23±0. 57 cm and gestation was 39. 85±1. 52 week. All of them were better than blank group (P<0. 01) . (4) In study group, there were one case with low birth weight infant, three cases with neonatal Apgar score<7’, and four cases with 20 items of neonatal behavioral neurological assessment score <36. The frequence of adverse gestation outcome was lower than the blank group (P<0. 01) . (5) Fourty-two days after birth, the neonatal weight in study group was 5. 09±0. 31 kg, height was 52. 43±1. 39 cm, and its head circumference was 36. 27±0. 66 cm. All the indexes were better than those in blank group (P<0. 01) . (6) There wasn’t significant difference among the change of maternal and neonatal liver and kidney function and plasma endothelin before and after therapy of all pregnant women in each group (P>0. 05) . Conclusion It’s safe and effective to treat fetal growth restriction with Breviscapine. It could improve pla-cental perfusion to increase fetal weight, reduce the frequence of low birth weight infant, and improve prognosis of perinatal outcome.更多还原