COX抑制剂对离体子宫平滑肌的作用研究

Effect of COX inhibitors on myometrial movement in vitro

目的探讨环氧合酶(COX)抑制剂对离体子宫平滑肌收缩活动的影响。方法将取自选择性剖宫产子宫平滑肌标本随机分为3组,即吲哚美辛(indomethacin,消炎痛)组、美洛昔康(meloxicam)组和对照组,用缩宫素诱导其收缩。前两组分别加入非选择性COX抑制剂吲哚美辛和选择性COX-2抑制剂美洛昔康,对照组不加药,其余处理3组相同。观察加药后子宫平滑肌收缩幅度、频率及持续时间的变化。结果与对照组相比,吲哚美辛、美洛昔康对缩宫素诱导子宫平滑肌收缩幅度、频率及持续时间有明显影响,且随着药物浓度的增加,平滑肌收缩力减弱,呈明显的剂量依赖性。后者的有效药物浓度低于前者。结论选择性COX-2抑制剂(美洛昔康)可明显抑制子宫平滑肌收缩,且效果好于非选择性COX抑制剂(吲哚美辛),对早产的治疗有潜在临床应用价值。

Objective To observe the effects of cyclooxygenase（COX） inhibitors on movement of myometrial strips from preg nant women in vitro. Methods Thirty examples of myometrial strips from pregnant women undergoing elective cesarean section were divided into three groups randomly：indomethacin group, meloxicam group and control group. After inducing myometrial strips with oxytocin, nonelective COX inhibor,indomethacin and elective COX-2 inhibitor, meloxicum were added to the strips in former 2 groups and no agent was given to control group. The amplitude,frequency and time of duration of myomtrial contraction were ob- served. Results Indomethacin and meloxicam exerted significant relaxation on contractility in pregnant nonlabor myometrial strip, including amplitude,frequency and duration. They had both dose-dependent inhibitory effects. Meloxicam showed better efficiency than indomethacin at 10μmol/L. Conclusion COX inhibitors have a significantly inhibitory effect on pregnant myometrium move ment in vitro. Meloxicam, a elective COX-2 inhibitor, shows more potent than indomethaein,a nonelective COX inhibitor. Our results suggest that elective COX-2 inhihitors may be used in clinic as tocolytic agents.