硝酸甘油贴膜治疗早产的临床效果及机理研究

目的　观察硝酸甘油贴膜治疗早产的临床效果 ,并初步探讨其作用机理。方法　 6 0例先兆早产患者随机分为硫酸镁加舒喘灵常规治疗组 (常规组 ,30例 )和硝酸甘油贴膜治疗组 (贴膜组 ,30例 ) ,两组孕妇治疗前、后分别抽取外周静脉血 ,采用放射免疫分析法测定血浆促肾上腺皮质激素释放激素 (CRH)水平。观察两组孕妇延迟分娩的时间。结果　 (1)贴膜组延迟分娩 4 8h ,有效率为90 % ,平均延长孕期 2 5d。常规组延迟分娩 4 8h ,有效率为 80 % ,平均延长孕期 8d。贴膜组延长先兆早产孕妇孕期效果明显优于常规组 (P <0 0 1)。 (2 )贴膜组孕妇血浆中CRH水平由治疗前的 (2 5 7±6 1)ng/L ,显著下降至治疗后的 (38± 17)ng/L。常规组孕妇血浆CRH水平由治疗前的 (2 4 8± 6 0 )ng/L ,显著降低至治疗后的 (5 6± 2 2 )ng/L ,两组比较 ,差异有极显著性 (P <0 0 1)。结论　硝酸甘油贴膜是一种安全有效的抗早产药物 ,其作用机理可能与降低血浆CRH水平有关

Clinical effect and mechanism of nitroglycerin patch on arresting preterm labor

OBJECTIVE: To observe the effect of nitroglycerin patch on treatment of preterm labour and to identify the mechanism responsible for arrest of preterm labour with nitroglycerin patch. METHODS: Sixty women diagnosed as threatened preterm labour were divided into two groups: group of nitroglycerin patch therapy (n = 30), and group of magnesium sulfate and salbutamol sulfate therapy (n = 30). Nitroglycerin patch was applied to the abdomen of patients. Measurement of cortictrophin-releasing hormone (CRH) levels in maternal plasma was performed by radioimmunoassay. RESULTS: The mean time of pregnancy prolongation was 25 days in the nitroglycerin patch group, and 8 days in the magnesium sulfate and salbutamol sulfate group. The mean level of CRH concentration in nitroglycerin patch group before treatment was (257 +/- 61) ng/L, and it was decreased sharply to (38 +/- 17) ng/L after treatment. Those were (248 +/- 60) ng/L and (56 +/- 22) ng/L respectively in the magnesium sulfate and salbutamol sulfate group. CONCLUSION: Reduction of CRH secretion may be the mechanism of nitroglycerin patch on preterm labour therapy. It may act as an effective, safe, well-tolerated, and non-invasive method for treatment of preterm labour.