Meinen K, Rahn M, Hermer M, Rominger K L, Kanitz T
Geburtshilflich-Gynäkologische Abteilung, St. Lukas Klinik Solingen.
Z Geburtshilfe Perinatol. 1988 Jul-Aug;192(4):163-8.
Clenbuterol is a betamimetic agent with a marked effect on the adrenergic beta-2-receptors relevant for tocolysis. The influence on beta-1-receptors of the heart, resulting in cardiovascular side effects is far less. The substance is resorbed almost completely enterally and has a half-life of 34 hours. Consequently, ingestion intervals of 12 hours are possible, resulting in a good acceptance of the tocolytic, therapy and a noticeable improvement of the patients compliance. Clenbuterol was applied in 37 cases in the course of a clinical test. Initially, the dose was 0.04 mg b.i.d., after 24 hours 0.02 mg b.i.d. In cases of cervix-effective, premature labor, an objectively measureable tocolytic effect was achieved. Subjectively reported side effects, i.e. palpation, tachycardia and tremor, were noticeably weaker than under fenoterol therapy. There was no indication of clenbuterol-related cardiotoxicity regarding continuous measurement of heart-specific enzymes, i.e. CK-MB and serum myoglobin. No pathologic alterations were found in the EKGs. Therefore, regarding indications and contraindications for beta-adrenergic agents, clenbuterol appears to have good tocolytic properties, with the advantages of less cardiac side effects, better compliance and a better dose-effect-ratio compared with the common oral tocolysis with fenoterol.
克仑特罗是一种β-拟交感神经药,对与安胎有关的肾上腺素能β2受体有显著作用。对心脏β1受体的影响较小,因此心血管副作用也较少。该物质几乎完全经肠道吸收,半衰期为34小时。因此,给药间隔为12小时是可行的,这使得安胎治疗的接受度良好,患者的依从性也有显著提高。在一项临床试验中,对37例患者使用了克仑特罗。最初剂量为0.04毫克,每日两次,24小时后减至0.02毫克,每日两次。对于宫颈扩张有效的早产病例,取得了客观可测量的安胎效果。主观报告的副作用,如心悸、心动过速和震颤,明显比使用非诺特罗治疗时要轻。连续测量心脏特异性酶(即肌酸激酶同工酶CK-MB和血清肌红蛋白),未发现与克仑特罗相关的心脏毒性迹象。心电图也未发现病理改变。因此,就β-肾上腺素能药物的适应证和禁忌证而言,克仑特罗似乎具有良好的安胎特性,与常用的口服安胎药非诺特罗相比,具有心脏副作用较少、依从性更好和剂量效应比更佳的优点。