宫缩抑制剂硝苯地平用于安胎治疗的研究进展

早产是导致围生儿发病和死亡的主要因素,防治早产一直是围生领域的重要课题。应用宫缩抑制剂是治疗早产的最有效手段之一,国内常用硫酸镁和利托君进行治疗,但其不良反应发生率高。国外临床试验表明硝苯地平的安胎效果优于β-肾上腺素受体激动剂利托君,与硫酸镁疗效无显著性差异,但不良反应发生率比利托君和硫酸镁小。此外,硝苯地平价格低廉,可口服给药,患者依从性好。因此,本文对国内外临床数据和文献资料进行分析总结,介绍硝苯地平用于安胎治疗的疗效和安全性。

Nifedipine for the Treatment of Preterm Labor

Preterm birth is the leading cause of perinatal morbidity and mortality. Several tocolytic agents have been used for the inhibition of uterine contractility, but it remains unclear what the first-line tocolytic agent should be. Nifedipine, a calcium channel blocker, targets at uterine smooth muscle and inhibits calcium influx, so as to achieve inhibition of uterine contractions. It has been widely used abroad for the treatment of preterm labor, but it is a start in China. Clinical trials demonstrated that nifedipine is superior toβ-adrenergic-receptor agonists and similar to magnesium sulfate in tocolytic efficacy, and is associated with significantly fewer maternal adverse events thanβ-adrenergic-receptor agonists and magnesium sulfate. Further, nifedipine is for oral administration and low cost. Thus, nifedipine have the potentiality of being the first-line tocolytic agent.