硫酸镁和硝苯地平联合治疗不会增加先兆子痫女性发生严重镁相关母体副作用的风险。

Therapy with both magnesium sulfate and nifedipine does not increase the risk of serious magnesium-related maternal side effects in women with preeclampsia.

作者信息

Magee Laura A, Miremadi Saman, Li Jing, Cheng Carol, Ensom Mary H H, Carleton Bruce, Côté Anne-Marie, von Dadelszen Peter

机构信息

Centre for Healthcare Innovation and Improvement, British Columbia Research Institute for Children's and Women's Health, Department of Specialized Women's Health, BC Women's Hospital and Health Centre, Canada.

出版信息

Am J Obstet Gynecol. 2005 Jul;193(1):153-63. doi: 10.1016/j.ajog.2004.11.059.

DOI:10.1016/j.ajog.2004.11.059

PMID:16021073

Abstract

OBJECTIVE

Does the use of nifedipine and magnesium sulfate together increase serious magnesium-related effects?

STUDY DESIGN

This was a retrospective chart review of women who were admitted to BC Women's Hospital and Health Centre (1997-2001) and were given intravenous magnesium sulfate for preeclampsia. Serious magnesium-related effects were compared among 162 cases who received magnesium sulfate and contemporaneous nifedipine and 215 control subjects who received magnesium sulfate and either another antihypertensive (n=32 women) or no antihypertensive (n=183 women) medication. Chi-squared test, Fisher's exact test, or the Student t test was used for data comparison between cases and each control group. A probability value of <.05 was considered statistically significant.

RESULTS

The cases had more severe preeclampsia and a longer magnesium sulfate infusion. However, cases had no excess of neuromuscular weakness (53.1%) versus control subjects who received antihypertensive medication (53.1%; P=.99) or control subjects who received no antihypertensive medication (44.8%; P=.13) or other serious magnesium-related effects. Cases versus control subjects who received antihypertensive medication had less neuromuscular blockade (odds ratio, 0.04; 95% CI, 0.002-0.80). Cases versus control subjects who received no antihypertensive medication had less maternal hypotension (41.4% vs 53.0%; P=.04).

CONCLUSION

The use of nifedipine and magnesium sulfate together does not increase the risk of serious magnesium-related effects.

摘要

目的

联合使用硝苯地平和硫酸镁是否会增加与镁相关的严重不良反应？

研究设计

这是一项对入住卑诗省妇女医院及健康中心（1997 - 2001年）且因先兆子痫接受静脉注射硫酸镁治疗的女性患者进行的回顾性病历审查。比较了162例接受硫酸镁及同期硝苯地平治疗的患者与215例对照患者的情况，后者接受硫酸镁及其他降压药（n = 32例女性）或未接受降压药（n = 183例女性）治疗。采用卡方检验、Fisher精确检验或Student t检验对病例组与各对照组的数据进行比较。概率值<0.05被认为具有统计学意义。

结果

病例组先兆子痫病情更严重，硫酸镁输注时间更长。然而，病例组出现神经肌肉无力的比例（53.1%）与接受降压药治疗的对照组（53.1%；P = 0.99）或未接受降压药治疗的对照组（44.8%；P = 0.13）相比并无增加，也未出现其他与镁相关的严重不良反应。与接受降压药治疗的对照组相比，病例组神经肌肉阻滞较少（优势比，0.04；95%可信区间，0.002 - 0.80）。与未接受降压药治疗的对照组相比，病例组产妇低血压较少（41.4%对53.0%；P = 0.04）。