Boutroy M J, Cramer P, Bianchetti G, Boutroy J L, Zipfel A, Régnier F, Morselli P L
INSERM U 272, pathologie et biologie du développement humain, Nancy, France.
Arch Mal Coeur Vaiss. 1989 Jul;82(7):1069-72.
The efficacy and the safety of betaxolol (BTX), a cardio-selective adrenoceptor blocking agent with a long half life, was tested in 22 hypertensive pregnant women. BTX doses varied from 10 to 40 mg/day. BTX given as monotherapy (n = 19) or associated to dihydralazine (n = 3) led to a satisfactory control of arterial blood pressure (ABP). In the mother, the drug was very well tolerated. (table; see text) The fetal safety, evaluated by mean of cardiotocography and echography was also satisfactory. Fetal heart rythm was significantly slowed following first intake of BTX and remained stable until delivery; there was only one case of intra-uterine growth retardation pre-existing to the pharmacological treatment. Nine deliveries were ceasarian [fetal distress (n = 1); poor control ABPI (n = 1); obstetrical reasons (n = 7)]. Seventeen neonates were full-term and six were premature (twins included). The state of neonates at birth was very satisfactory (Apgar at 5 minutes greater than 9 in 21/23). Glycemia less than 1.66 mmoles/1 in two neonates, was normal within 24 to 48 hours. In conclusion, BTX was very efficacious in controlling increased blood pressure in pregnant women and its safety in the mother, the fetus and the newborn was very good.
倍他洛尔(BTX)是一种半衰期较长的心脏选择性肾上腺素能受体阻滞剂,对22名高血压孕妇进行了其疗效和安全性测试。BTX剂量为每日10至40毫克。单独使用BTX(n = 19)或与双肼屈嗪联合使用(n = 3)均能使动脉血压(ABP)得到满意控制。在母亲方面,该药物耐受性良好。(表格;见正文)通过胎心监护和超声评估的胎儿安全性也令人满意。首次服用BTX后胎儿心率显著减慢,并一直保持稳定直至分娩;药物治疗前仅出现1例宫内生长迟缓病例。9例分娩为剖宫产[胎儿窘迫(n = 1);ABPI控制不佳(n = 1);产科原因(n = 7)]。17例新生儿为足月儿,6例为早产儿(包括双胞胎)。新生儿出生时状况非常令人满意(23例中有21例5分钟阿氏评分大于9分)。2例新生儿血糖低于1.66毫摩尔/升,在24至48小时内恢复正常。总之,BTX在控制孕妇血压升高方面非常有效,其对母亲、胎儿和新生儿的安全性也非常好。