宫缩抑制剂的应用进展

Application Progress of Tocolytic Drugs

宫缩抑制剂的应用是早产或先兆早产治疗中最重要的治疗手段。目前常用宫缩抑制剂有β2肾上腺素受体激动剂(盐酸利托君)、硫酸镁、缩宫素受体拮抗剂(阿托西班)、钙离子通道拮抗剂(硝苯地平)、前列腺素合成酶抑制剂、一氧化氮供体等。盐酸利托君保胎效果明显,但可能导致孕妇代谢紊乱及心血管不良反应。硫酸镁主要是由于其对早产儿神经系统的保护作用而在临床上广泛使用。阿托西班不良反应小,但费用昂贵受到了一定的限制。硝苯地平保胎效果明显,但也有少许不良反应。吲哚美辛保胎作用明显,但可能导致羊水过少。临床工作中应结合具体孕妇的病情需要及自身条件,选择恰当的宫缩抑制剂从而达到最佳的治疗效果。

The application of tocolytic drugs is the most important treatment in preterm delivery. Currently tocolytic drugs include β2 adrenergic receptor agonists( ritodrine hydrochloride),magnesium sulfate,oxytocin receptor antagonists( atosiban),calcium channel antagonists( nifedipine),prostaglandin synthase inhibitors( indometacin),nitric oxide donors and so on. Ritodrine hydrochloride has obvious effect,but may lead to metabolic disorders and cardiovascular side effects in pregnant women. Magnesium sulfate is widely used due to its neuroprotective effect on preterm infants. Atosiban has less adverse effect,but is less used due to its high fee. The effect of nifedipine is obvious,but there are also a few adverse effects. Indomethacin has obvious effect,but may lead to oligohydramnios. The application in clinical work should combine the specific needs of the pregnant women and their own conditions and select the appropriate tocolytics to achieve the best therapeutic effect.