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二氮嗪对母婴血流动力学的影响。

Maternal and fetal hemodynamic effects of diazoxide.

作者信息

Nuwayhid B, Brinkman C R, Katchen B, Symchowicz S, MARTINEK H, Assali N S

出版信息

Obstet Gynecol. 1975 Aug;46(2):197-203.

PMID:239372
Abstract

Effects of diazoxide on systemic and uterine hemodynamics as well as on fetal circulation and blood respiratory gases were investigated in chronically instrumented pregnant sheep. Diazoxide was administered intravenously either to the ewe or directly to the fetus in doses calculated on the basis of body weight. Transfer of drug across placenta was also investigated. Results showed that: a) when injected into the mother, there was consistent hypotensive effect with increased cardiac output and decreased systemic vascular resistance; uterine blood flow might not change or might decrease slightly with moderate hypotension; when maternal systemic arterial pressure fell to critical closing pressure level, uterine flow decreased significantly; but despite these maternal changes, the fetal circulatory functions were not significantly altered; b) when injected into the fetus in doses up to 15 mg/kg, diazoxide failed to alter fetal circulation appreciably; c) diazoxide crossed the placenta when injected intoeither mother or fetus according to a definite gradient; fetal levels were always lower than maternal levels because of rapid loss of the drug by the fetus; d) moderate maternal and fetal hyperglycemia occurred after drug administration.

摘要

在长期植入仪器的怀孕绵羊中,研究了二氮嗪对全身和子宫血流动力学以及对胎儿循环和血液呼吸气体的影响。根据体重计算剂量,将二氮嗪静脉注射给母羊或直接注射给胎儿。还研究了药物通过胎盘的转运情况。结果表明:a)注射到母体时,有持续的降压作用,心输出量增加,全身血管阻力降低;子宫血流量可能不变或在中度低血压时略有下降;当母体全身动脉压降至临界关闭压水平时,子宫血流量显著下降;但尽管母体有这些变化,胎儿循环功能并未显著改变;b)以高达15mg/kg的剂量注射到胎儿体内时,二氮嗪未能明显改变胎儿循环;c)当注射到母体或胎儿体内时,二氮嗪根据一定梯度穿过胎盘;由于胎儿迅速失去药物,胎儿体内的水平总是低于母体水平;d)给药后母体和胎儿出现中度高血糖。

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