硝苯地平治疗妊高征母婴血药浓度监测

Determination of nifedipine plasma concentration of mothers and fetuses in pregnancy induced hypertension

目的 测定硝苯地平治疗妊高征的母婴血药浓度。方法 15例妊高征患者孕期舌下服用不同剂量硝苯地平后,用反相高效液相色谱法测定母婴血药浓度水平,并进行各项指标相关性分析。结果 较长时间(1～52天)服用不同剂量(10～1450 mg)硝苯地平治疗妊高征,分娩时,产妇血浆中硝苯地平浓度为(26.91±20.93) mg.L-1,脐静脉血为(15.96±12.08) mg.L-1,胎儿与产妇血药浓度之比为0.61±0.22,分娩时母婴血药浓度均与母亲服药总量呈低度正相关。脐静脉硝苯地平血药浓度与新生儿1minApgar评分无统计学相关性。结论 母婴血药浓度随母亲服药总量增加而增加,均在有效血药浓度范围,母婴均无蓄积中毒。胎儿血药浓度不影响新生儿评分。

Objective To study nifedipine plasma concentration of treatment pregnancyinduced hypertension and its effects on mothers and fetuses. Methods Highperformance liquid chromatography was used to determined the nifedipineconcentration of the mother and fetus in plasma in fifteen patients who wereadministered sublingual nifedipine of various doses in pregnancy period. ResultsThe mean maternal plasma concentration of nifedipine before dilivery was (26.91±20.93) mg.L-1.The fetal nifedipine concentration was (15.96±12.08) mg.L-1 in theumbilical vein at the birth.The umbilical venous-maternal ratio of nifedipine was0.61±0.22.There were positive correlations between the concentration of nifedipinein mother or fetus and total doses in adminitration to mother (P<0.05). No significantcorrelation was found between fetal nifedipine concentration level and neonatalApgar score. Conclusion The concentrations of nifedipine in mother or fetusincreased with total doses in adminitration to mother.They were in normal effectiveconcentration range , and by far lower than the toxic concentration (250mg.L-1).Thereare no cumulative intoxication in mother and fetus. The concentration of nifedipinein fetus do not affect neonatal Apgar score.