Andersen L F, Lyndrup J, Akerlund M, Melin P
Department of Obstetrics and Gynecology, Hvidovre Hospital, University of Copenhagen, Denmark.
Am J Perinatol. 1989 Apr;6(2):196-9. doi: 10.1055/s-2007-999575.
The concentration of myometrial and decidual oxytocin receptors increases dramatically in normal women in late pregnancy, causing enhanced uterine sensitivity to physiologic levels of oxytocin. Similar increase in myometrial oxytocin receptors has been found in women in preterm labor, indicating a role for oxytocin also in idiopathic preterm labor. A newly synthesized oxytocin analogue, 1-deamino-2-D-Tyr-(OEt)-4-Thr-8-Orn-oxytocin, has been found to be a competitive inhibitor of oxytocin. The present study was conducted to test its efficacy in suppressing uterine contractions during preterm labor in women. Twelve patients with established, uncomplicated preterm labor between 27 and 33 weeks of gestational age were given intravenous infusions of the analogue for 1.5 to 13 hours during continuous external cardiotocographic monitoring. In nine patients inhibition of uterine contractions was achieved and further progression in cervical scores was arrested. In three patients, all at 27 weeks of gestational age, no significant tocolytic effect was observed during a 1.5-hour infusion of the analogue and the patients were then given ritodrine intravenously. No side effects were observed in any of the patients. These preliminary findings support the concept that an increased concentration of uterine oxytocin receptors is an important etiologic factor in uncomplicated preterm labor and therefore oxytocin receptor blockade may be a therapeutic alternative for this condition.
在正常妊娠晚期，孕妇子宫肌层和蜕膜中催产素受体的浓度会急剧增加，使子宫对生理水平的催产素敏感性增强。在早产的女性中也发现子宫肌层催产素受体有类似增加，这表明催产素在特发性早产中也起作用。一种新合成的催产素类似物，1-脱氨基-2-D-酪氨酸-（乙酯）-4-苏氨酸-8-鸟氨酸催产素，已被发现是催产素的竞争性抑制剂。本研究旨在测试其在抑制早产女性子宫收缩方面的疗效。对12例孕27至33周确诊为无并发症早产的患者，在持续外部胎心监护期间静脉输注该类似物1.5至13小时。9例患者子宫收缩得到抑制，宫颈评分进一步进展停止。3例均为孕27周的患者，在输注该类似物1.5小时期间未观察到明显的宫缩抑制作用，随后给予静脉注射利托君。所有患者均未观察到副作用。这些初步研究结果支持这样的观点，即子宫催产素受体浓度增加是无并发症早产的一个重要病因，因此催产素受体阻断可能是治疗这种情况的一种替代方法。
