催产素用于催引产的临床药理学研究现状

Research status of clinical pharmacology development of oxytocin for induction and augmentation of labor

静脉输注催产素是产科最常见且安全的催引产方式,然而目前其给药方案仍无“金标准”,包括初始输注速率、单次递增速率、递增间隔、持续输注时间和最大输注速率等方面,各国指南中的推荐不尽相同,其主要原因在于催产素的作用机制研究尚不透彻,其剂量-暴露-效应的定量关系尚未明确。目前,研究显示,催产素诱发宫缩的机制通路多样,且受多种因素影响,催产素用于催引产的药代动力学和药效学过程在个体间也存在较大的变异。本文就催产素用于催引产的临床药理学特征进行介绍,同时对影响其临床药效的因素进行总结,以期为催产素临床给药方案的优化提供新的思路。

Intravenous infusion of oxytocin is the most common and safe way for the induction and augmentation of labor in obstetrics.However,including starting dose,incremental increase,dosage interval,dosage time and maximum dose,no"golden standard"of regimen has been established until now,which is caused by the lack of studies on mechanism and dose-exposure-response relationship of oxytocin.Currently,some studies have shown that uterine contraction induced by oxytocin has various mechanisms,and which is influenced by many factors.The pharmacokinetics and pharmacodynamics of oxytocin also have greatly variations.In this paper,the clinical pharmacology characteristics of oxytocin for induction and augmentation of labor were reviewed,and the known mechanism and the influencing factors for clinical efficacy of oxytocin were summarized,hoping to provide new ideas to optimize the regimen of oxytocin.