Homiladorlik davrida nazoratda bo‘lmagan arterial gipertenziyada kombinatsiyalangan davolash usullarining klinik samaradorligi
Qabul qilingan: 2025-12-12 11:51:19
Nashr etilgan: 2026-03-29
Annotatsiya
Maqsad: Nazoratda bo‘lmagan gestatsion arterial gipertenziyaga ega homilador ayollarda kombinatsiyalangan antigipertenziv terapiyaning arterial qon bosimi ko‘rsatkichlariga ta’sirini baholash.
Materiallar va usullar: Tadqiqotga 2018-yilgi ESC tavsiyalariga muvofiq gestatsion arterial gipertenziya tashxisi qo‘yilgan, homiladorlik muddati 20–24 hafta bo‘lgan 60 nafar homilador ayol kiritildi. Bemorlar tasodifiy ravishda ikki guruhga ajratildi: 1-guruh (n = 30) — metildopa (500–1000 mg) + metoprolol suksinat (25–50 mg), 2-guruh (n = 30) — metildopa (500–1000 mg) + amlodipin (5–10 mg). Barcha bemorlarda antigipertenziv terapiya boshlanishidan oldin ofis arterial bosimi o‘lchandi va sutkalik arterial qon bosimi monitoringi o‘tkazildi.
Natijalar: Ikkala guruhda ham sistolik, diastolik va o‘rtacha arterial qon bosimining ishonchli pasayishi qayd etildi (p < 0,0001). Arterial bosimning pasayish darajasi 2-guruhda sistolik va diastolik ko‘rsatkichlar bo‘yicha yuqoriroq bo‘ldi, bu amlodipinning vazodilatatsion ta’siri bilan izohlanishi mumkin. Maqsadli sistolik qon bosimi 1-guruh bemorlarining 75% da, 2-guruh bemorlarining 87% da, maqsadli diastolik qon bosimi esa mos ravishda 75% va 91% bemorlarda kuzatildi. Biroq guruhlar o‘rtasida statistik ahamiyatli farq aniqlanmadi.
Xulosa: Ikkala kombinatsiyalangan antigipertenziv terapiya sxemasi ham gestatsion arterial gipertenziyaga ega homilador ayollarda maqsadli arterial qon bosimi darajasiga erishishni ta’minladi. Metildopa va amlodipin kombinatsiyasida qon bosimi pasayish tendensiyasi yuqoriroq bo‘lgan bo‘lsa-da, ushbu natijalarni tasdiqlash uchun kengroq tadqiqotlar talab etiladi.
Kalit so‘zlar
Adabiyotlar ro'yxati
-
Khan, K. S., Wojdyla, D., Say, L., Gülmezoglu, A. M., and Van Look, P. F. (2006). WHO analysis of causes of maternal death: a systematic review. Lancet 367 (9516), 1066–1074. https://doi.org/10.1016/S0140-6736(06)68397-9.
-
Hitti, J., Sienas, L., Walker, S., Benedetti, T. J., and Easterling, T. (2018). Contribution of hypertension to severe maternal morbidity. Am. J. Obstet. Gynecol. 219 (4), e1–e405. https://doi.org/10.1016/j.ajog.2018.07.002
-
Magee LA, von Dadelszen P, Rey E, et al. Control of hypertension in pregnancy (CHIPS) trial. BMJ. 2015;350:h349. https://doi.org/10.1136/bmj.h349.
-
Tita ATN, Szychowski JM, Boggess K, et al. Treatment for Mild Chronic Hypertension during Pregnancy (CHAP Trial). N Engl J Med. 2022;386:1781–1792.
-
Gestational Hypertension and Preeclampsia (2020). Gestational hypertension and preeclampsia: ACOG practice bulletin, number 222. Obstetrics Gynecol. 135 (6), e237–e260. https://doi.org/10.1097/AOG.0000000000003891
-
https://doi.org/10.1056/NEJMoa2201295 De Backer J., Haugaa K., et al. 2025 ESC Guidelines for the management of cardiovascular disease and pregnancy. European Heart Journal. 2025;00:1-107. https://doi.org/10.1093/eurheartj/ehaf193.
-
Koopmans CM, Bijlenga D, Groen H, et al. Induction of labour versus expectant monitoring for gestational hypertension or mild pre-eclampsia after 36 weeks’ gestation (HYPITAT trial): a multicentre, open-label randomised controlled trial. Lancet. 2009;374(9694):979-988. https://doi.org/10.1016/S0140-6736(09)60736-4.
-
Broekhuijsen K, van Baaren GJ, van Pampus MG, et al. Immediate delivery versus expectant monitoring for hypertensive disorders of pregnancy between 34 and 37 weeks of gestation (HYPITAT-II): a multicentre, ISSN: 3060-4850; CARDIOLOGY OF UZBEKISTAN 2026; 3 (1). 25 of 25 open-label randomised controlled trial. Lancet. 2015;385(9986):2492-2501. https://doi.org/10.1016/S0140-6736(14)61998-X.
-
Abalos E., Duley L., Steyn D.W., Henderson-Smart D.J. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. Cochrane Database of Systematic Reviews. 2018, Issue 10. Art. No.: CD002252. https://doi.org/10.1002/14651858.CD002252.pub4.
-
Sridharan K., Sequeira R.P. Drugs for treating severe hypertension in pregnancy: a network meta-analysis and trial sequential analysis of randomized clinical trials. Br J Clin Pharmacol. 2018;84(9):1906-1916. https://doi.org/10.1111/bcp.13649.PMID:29974489.
-
George R., Thomas C., Anna Joy C., Varghese B., Undela K., Adela R. Comparative efficacy and safety of oral nifedipine with other antihypertensive medications in the management of hypertensive disorders of pregnancy: a systematic review and meta-analysis of randomized controlled trials. J Hypertens. 2022;40(10):1876–1886. https://doi.org/10.1097/HJH.0000000000003233.
-
Yin J., Mei Z., Shi S., Du P., Qin S. Nifedipine or amlodipine? The choice for hypertension during pregnancy: a systematic review and meta-analysis. Arch Gynecol Obstet. 2022; 306(6): 1891–1900. https://doi.org/10.1007/s00404-022-06504-5.
-
Bajpai D., Popa C., Verma P., Dumanski S., Shah S. Evaluation and Management of Hypertensive Disorders of Pregnancy. Kidney360. 2023;4(10):1512-1525. https://doi.org/10.34067/KID.0000000000000228
Mualliflar haqida
Litsenziya
Mualliflik huquqi (c) 2026 Мохинур Садуллоева, Феруза А. Закирова (Автор)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Qanday iqtibos keltirish kerak
