Department of Obstetrics and Gynecology, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan.
J Perinatol. 2012 Jun;32(6):466-8. doi: 10.1038/jp.2011.132.
Intrauterine infection and inflammation are recognized as major contributors to the onset of preterm labor. We describe two cases of severe preterm labor with bulging membrane that were treated by intravenous injection of Sivelestat, a neutrophil elastase inhibitor. Ritodrine hydrochloride and magnesium sulfate were intravenously administered for tocolysis, and ampicillin was provided as an antibiotic. Urinary trypsin inhibitor (UTI) was administered transvaginally. Sivelestat was infused intravenously at 4.8 mg kg(-1) day(-1) through the maternal vein. No side effects were observed. Levels of interleukin (IL)-6 and IL-8 in amniotic fluid decreased, and gestations were prolonged without complications for >1 week. Two healthy infants were delivered. Our experience suggests that multidrug therapy with Sivelestat offers a new therapeutic strategy for preterm labor, but further investigations of the indications, administration period and dosage are required.
宫内感染和炎症被认为是早产的主要原因。我们描述了两例因胎膜膨出而出现严重早产的病例，采用注射型中性粒细胞弹性蛋白酶抑制剂西维来司他钠进行治疗。静脉滴注盐酸利托君和硫酸镁进行宫缩抑制，氨苄西林作为抗生素。经阴道给予尿胰蛋白酶抑制剂（UTI）。西维来司他钠通过母体静脉以 4.8mg/kg/d 的剂量静脉滴注。未观察到不良反应。羊水中白细胞介素（IL）-6 和 IL-8 的水平下降，且妊娠延长超过 1 周而无并发症。两名健康婴儿顺利分娩。我们的经验表明，西维来司他钠的多药物治疗为早产提供了一种新的治疗策略，但需要进一步研究其适应证、给药期和剂量。
