利托君抑制宫缩时孕妇心率变化的初步研究

The preliminary study of the effect of ritodrine on the change of heart rate in threatened premature labor

目的 探讨利托君抑制宫缩时孕妇心率的变化与治疗的关系。方法 选择先兆早产孕妇 110例。将利托君 10 0mg加入 5 %葡萄糖溶液 5 0 0mL中静脉滴注 ,从 6滴 (每分钟 )开始 ,根据疗效调整药物剂量 ,待宫缩消失后维持 40 48小时或更长 ,以后改口服 ,病情反复者可重复用药。比较用药前后孕妇心率的变化及与药物剂量的关系 ,并分析分娩时间、胎儿重量和Apgar评分等指标。 结果 孕妇基础心率与孕周之间呈较典型的先升后降的变化趋势。静滴利托君至宫缩停止时 ,孕妇心率明显增加 (P <0 0 1) ,但不同孕周之间的心率无显著差异 (P>0 0 5 )。随着利托君用药剂量的增加 ,孕妇心率呈剂量依赖性升高 ,最高峰不超过 140 /min。用药后孕妇分娩时间明显延长 (P <0 0 1) ,其中单纯先兆早产者延长最多 (P <0 0 5 )。胎儿平均体重 (2 42± 0 49)kg ,平均Apgar评分≥ 8分。 结论 在抑制宫缩治疗中利托君介导的孕妇心率增加可作为评价药物疗效的指标之一。

Objective To determine the change of maternal heart rate during the treatment with ritodrine for threatened premature labor.Methods 110 cases of threatened premature labor were chosen.The ritodrine 100mg in 5%G.S 500mL was intravenously administered.The initial dosage was 6 drops/min,and the dose was increased until uterine contractions were inhibited.The treatment lasted for 40 to 48 hours after the uterine contractions were inhibited,then the oral tablets was recommended.If necessary,repeated treatment was given to some patients.The maternal heart rate was recorded in the whole process of treatment and was compared with the dosage administered.The labor time,fetal weight and Apgar's score were also analyzed.Results The maternal basic heart rate was increased at first and then decreased.The increasing significantly increased(P<0 01) when the uterine contraction was inhibited.,but no difference showed among the groups of different gestational age(P>0 05).The maternal heart rate was increased with the increasing of ritodrine(max.140/min).labor time was significantly prolonged with the treatment of ritodrine(P<0 01),while that of the idiopathic premature labor was prolonged most obviously(P<0 05).Average fetal weight was (2 42±0 49)kg,and the average Apgar's score was ≥8.Conclusion In the treatment of inhibiting uterine contractions,the increasing of maternal heart rate caused by ritodrine can be used as an indicator of therapeutic effect.