广西医学

目的探讨硝苯地平联合盐酸利托君治疗早产胎膜早破（PROM）患者的疗效及其对外周血炎症细胞因子的影响。方法选取146例早产PROM患者作为研究对象，采用随机数字表法将患者分为研究组与常规组，各73例。给予常规组硫酸镁注射液及盐酸利托君片治疗，在常规组基础上，给予研究组硝苯地平治疗。比较两组疗效、母婴相关指标（宫缩抑制时间、孕龄延长时间、新生儿Apgar评分、新生儿出生体重）、治疗前后炎症细胞因子［高迁移率族蛋白B1（HMGB1）、可溶性Toll样受体4（sTLR4）、氧化型α1⁃抗胰蛋白酶（ox⁃AAT）］水平，以及新生儿并发症发生率、治疗期间患者不良反应发生情况。结果研究组的总有效率高于常规组，宫缩抑制时间短于常规组，孕龄延长时间长于常规组，新生儿Apgar评分、出生体重高于或大于常规组（P<0.05）。治疗后，研究组的血清HMGB1、sTLR4、ox⁃AAT水平低于治疗前及常规组（P<0.05）。研究组新生儿并发症总发生率低于常规组（P<0.05），而两组患者不良反应总发生率的差异无统计学意义（P>0.05）。结论硝苯地平联合盐酸利托君治疗早产PROM患者，可延长孕龄时间，缓解炎症反应，改善妊娠结局，且未明显增加不良反应。

Objective To investigate the efficacy of nifedipine combined with ritodrine hydrochloride for the treatment of patients with preterm premature rupture of membranes (PROM) and its influence on peripheral blood inflammatory cytokines. Methods A total of 146 preterm PROM patients were selected as the research subjects, and they were divided into study group or routine group by the random number table method, with 73 cases in each group. The routine group was treated with Magnesium Sulfate Injection and Ritodrine Hydrochloride Tablets, based on which the study group was treated with nifedipine. The efficacy, maternal and infant relevant indices (contraction inhibition time, prolongation of gestational age, neonatal Apgar score, neonatal birth weight), pre⁃ and post⁃treatment inflammatory cytokines (high mobility group protein B1 ［HMGB1］, soluble Toll⁃like receptor 4 ［sTLR4］, oxidized α1⁃antitrypsin ［ox⁃AAT］) levels, as well as the incidence rate of complications in neonates, and the occurrence of adverse reactions in patients during treatment were compared between the two groups. Results The study group exhibited a higher total effective rate, shorter contraction inhibition time, longer prolongation of gestational age, a higher score of neonatal Apgar, and greater birth weight as compared with the routine group (P<0.05). After treatment, the study group yielded lower levels of serum HMGB1, sTLR4, ox⁃AAT as compared with before treatment and the routine group (P<0.05); furthermore, the study group interpreted a lower total incidence rate of neonatal complications as compared with the routine group (P<0.05); however, there was no statistically significant difference in the total incidence rate of adverse reactions in patients between the two groups (P>0.05). Conclusion Nifedipine combined with ritodrine hydrochloride for the treatment of preterm PROM patients can prolong time for gestational age, relieve inflammation responses, and ameliorate pregnancy outcomes, and there is no significantly increased adverse reactions.