硝酸甘油贴膜治疗早产的临床效果及机理研究  

Clinical effect and mechanism of nitroglycerin patch on arresting preterm labor

作　　者：贺茜[1] 沙金燕[1] 顾清[1] 古航[1] 陈雄[1] 杨宙辉 宁红燕[1] 

机构地区：[1]第二军医大学长海医院妇产科,上海200433 [2]上海市杨浦区妇幼保健院

出　　处：《中华妇产科杂志》2002年第3期134-135,共2页Chinese Journal of Obstetrics and Gynecology

基　　金：国家自然科学基金资助 (3 9670 75 7)

摘　　要：目的　观察硝酸甘油贴膜治疗早产的临床效果 ,并初步探讨其作用机理。方法　 6 0例先兆早产患者随机分为硫酸镁加舒喘灵常规治疗组 (常规组 ,30例 )和硝酸甘油贴膜治疗组 (贴膜组 ,30例 ) ,两组孕妇治疗前、后分别抽取外周静脉血 ,采用放射免疫分析法测定血浆促肾上腺皮质激素释放激素 (CRH)水平。观察两组孕妇延迟分娩的时间。结果　 (1)贴膜组延迟分娩 4 8h ,有效率为90 % ,平均延长孕期 2 5d。常规组延迟分娩 4 8h ,有效率为 80 % ,平均延长孕期 8d。贴膜组延长先兆早产孕妇孕期效果明显优于常规组 (P <0 0 1)。 (2 )贴膜组孕妇血浆中CRH水平由治疗前的 (2 5 7±6 1)ng/L ,显著下降至治疗后的 (38± 17)ng/L。常规组孕妇血浆CRH水平由治疗前的 (2 4 8± 6 0 )ng/L ,显著降低至治疗后的 (5 6± 2 2 )ng/L ,两组比较 ,差异有极显著性 (P <0 0 1)。结论　硝酸甘油贴膜是一种安全有效的抗早产药物 。Objective To observe the effect of nitroglycerin patch on treatment of preterm labour and to identify the mechanism responsible for arrest of preterm labour with nitroglycerin patch. Methods Sixty women diagnosed as threatened preterm labour were divided into two groups: group of nitroglycerin patch therapy ( n =30), and group of magnesium sulfate and salbutamol sulfate therapy ( n =30). Nitroglycerin patch was applied to the abdomen of patients. Measurement of cortictrophin releasing hormone (CRH) levels in maternal plasma was performed by radioimmunoassay. Results The mean tiem of pregnancy prolongation was 25 days in the nitroglycerin patch group, and 8 days in the magnesium sulfate and salbutamol sulfate group. The mean level of CRH concentration in nitroglycerin patch group before treatment was (257±61) ng/L, and it was decreased sharply to (38±17) ng/L after treatment. Those were (248±60) ng/L and (56±22) ng/L respectively in the magnesium sulfate and salbutamol sulfate group. Conclusion Reduction of CRH secretion may be the machanism of nitroglycerin patch on preterm labour therapy. It may act as an effective, safe, well tolerated, and non invasive method for treatment of preterm labour.

关 键 词：早产 硝酸甘油 促肾上腺皮质素释放激素 临床疗效 

分 类 号：R714.21[医药卫生—妇产科学]