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目的探讨异丙酚对妊娠期高血压(HDCP)并脑出血(ICH)患者血清白介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)水平及分娩结局的影响。方法选取2014年2月—2016年5月海口市澄迈县人民医院收治的HDCP并ICH患者81例,采用随机数字表法分为对照组40例和观察组41例。对照组患者予以常规治疗,观察组患者在常规治疗基础上予以异丙酚治疗。比较两组患者治疗前后血压(收缩压、舒张压)、美国国立卫生研究院卒中量表(NIHSS)评分及血清IL-1β、TNF-α水平,妊娠结局及不良反应发生情况。结果治疗前两组患者收缩压、舒张压、NIHSS评分比较,差异无统计学意义(P>0.05);治疗后观察组患者收缩压、舒张压、NIHSS评分低于对照组(P<0.05)。治疗前两组患者血清IL-1β、TNF-α水平比较,差异无统计学意义(P>0.05);治疗后观察组患者血清IL-1β、TNF-α水平低于对照组(P<0.05)。观察组患者行剖宫产者所占比例、早产者所占比例及产后出血、胎儿窘迫、新生儿窒息发生率低于对照组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论异丙酚可有效降低HDCP并ICH患者血压及血清TNF-α、IL-1β水平,促进患者神经功能恢复,改善患者分娩结局,且安全性较高。
Objective To investigate the effects of propofol on serum levels of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α) and delivery outcomes in patients with HDCP complicated with intracerebral hemorrhage (ICH). Methods Eighty-one HDCP patients with ICH admitted to Chengmai People’s Hospital of Haikou from February 2014 to May 2016 were divided into control group (n = 40) and observation group (n = 41) by random number table. Patients in the control group were treated routinely, and patients in the observation group were treated with propofol on the basis of routine treatment. Blood pressure (systolic blood pressure, diastolic blood pressure), NIHSS score, serum IL-1β, TNF-α levels, pregnancy outcome and adverse reactions were compared between the two groups before and after treatment. Results Before treatment, systolic blood pressure, diastolic blood pressure and NIHSS score were not significantly different (P> 0.05). Systolic blood pressure, diastolic blood pressure and NIHSS score in observation group were lower than those in control group after treatment (P <0.05). The levels of IL-1β and TNF-α in the two groups before treatment were significantly lower than those in the control group (P 0. 05) . The incidence of cesarean section, the proportion of preterm birth, postpartum hemorrhage, fetal distress and neonatal asphyxia in observation group were lower than those in control group (P <0.05). Two groups of patients with adverse reactions, the difference was not statistically significant (P> 0.05). Conclusion Propofol can effectively reduce the blood pressure and serum levels of TNF-α and IL-1β in patients with HDCP and ICH, promote the recovery of neurological function, and improve the outcomes of patients with delivery. The propofol is safe and safe.