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四种常用镇痛药对大鼠的经胎盘心血管效应

Transplacental cardiovascular effects of four popular analgesics in rats.

作者信息

Momma K, Takao A

机构信息

Department of Pediatric Cardiology, Tokyo Women's Medical College, Japan.

出版信息

Am J Obstet Gynecol. 1990 May;162(5):1304-10. doi: 10.1016/0002-9378(90)90042-6.

Abstract

The purpose of this study is to clarify fetal cardiovascular effects of four popular analgesics administered to a maternal animal model. Clinical doses of aspirin (14 mg/kg), acetaminophen (14 mg/kg), ibuprofen (6 mg/kg), or indomethacin (0.7 mg/kg) were administered orally to near-term rats. At 1, 4, 8, or 24 hours later fetuses were delivered by cesarean section, and were fixed immediately by the whole-body freezing technique. The ductus diameter, pericardial effusion, and volume and mass of the ventricles were studied by photographing multiple planes of the heart. Fetal ductal constriction was most remarkable with ibuprofen, with the diameter decreased 70% +/- 5% (mean +/- SEM) at 1 to 8 hours. Both ventricles were dilated 60% +/- 27%, and pericardial fluid was increased 120% +/- 20%. These changes partly disappeared at 24 hours. Milder but more persistent effects were observed with indomethacin. The fetal ductus was constricted 30% at 4 to 24 hours. Pericardial fluid was increased 140% +/- 30% at 24 hours. Aspirin and acetaminophen constricted the fetal ductus 10%. In conclusion, clinical doses of ibuprofen and indomethacin constricted the fetal rat ductus and caused cardiac failure. The effects of aspirin and acetaminophen were much milder.

摘要

本研究的目的是阐明给母本动物模型施用四种常用镇痛药对胎儿心血管系统的影响。将临床剂量的阿司匹林(14毫克/千克)、对乙酰氨基酚(14毫克/千克)、布洛芬(6毫克/千克)或吲哚美辛(0.7毫克/千克)口服给予接近足月的大鼠。在1、4、8或24小时后,通过剖宫产取出胎儿,并立即采用全身冷冻技术进行固定。通过拍摄心脏的多个平面来研究动脉导管直径、心包积液以及心室的容积和质量。布洛芬导致的胎儿动脉导管收缩最为显著,在1至8小时时直径下降70%±5%(平均值±标准误)。两个心室均扩张60%±27%,心包液增加120%±20%。这些变化在24小时时部分消失。吲哚美辛的影响较轻但更持久。在4至24小时时胎儿动脉导管收缩30%。在24小时时心包液增加140%±30%。阿司匹林和对乙酰氨基酚使胎儿动脉导管收缩10%。总之,临床剂量的布洛芬和吲哚美辛使胎鼠动脉导管收缩并导致心力衰竭。阿司匹林和对乙酰氨基酚的影响要温和得多。

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