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[在宫缩抑制中额外使用镁剂治疗:临床化学监测参数]

[Additional magnesium therapy in tocolysis: clinico-chemical monitoring parameters].

作者信息

Spätling L

出版信息

Geburtshilfe Frauenheilkd. 1984 Jan;44(1):19-24. doi: 10.1055/s-2008-1036419.

DOI:10.1055/s-2008-1036419
PMID:6559720
Abstract

Pregnancy can result in magnesium deficiency, which may precipitate premature labour usually reversed by betamimetic therapy. Inclusion of magnesium in tocolytic therapy is useful for possible reduction of premature labour as well as for cardioprotection. 35 patients with premature labour received Fenoterol + 20 mmol/day magnesium aspartate hydrochloride (Mg-asp-HCl) orally or 30 or 40 mmol/day Mg-asp-HCl and magnesium sulphate (MgSO4) (1:1) i.v. Before and during this therapy, Mg, Ca, K, Na, Cl, creatinin and urea as well as human placental lactogen (HPL) and oestriol (E3) were determined. There were no significant changes in the level of these under oral magnesium therapy. Under intravenous administration, plasma levels of magnesium rose significantly. In the following weeks, the levels dropped in spite of continuing the therapy. The other parameters showed no important changes. Under i.v. administration of 40 mmol/day Mg-asp-HCl, the HPL increase was highly significant. If this could be taken as a hint of better placental function such a positive side effect of magnesium therapy could prove beneficial to "small-for-age" foetuses. Co-medication of 20 mmol/day Mg-asp-HCl (oral) or 40 mmol/day Mg-asp-HCl and MgSO4 (1:1, i.v.) is recommended.

摘要

怀孕可能导致镁缺乏,这可能会引发早产,而β-拟交感神经药物疗法通常可逆转这种情况。在宫缩抑制剂治疗中加入镁,对于可能减少早产以及心脏保护都很有用。35例早产患者口服非诺特罗加20毫摩尔/天的盐酸门冬氨酸镁(Mg-asp-HCl),或静脉注射30或40毫摩尔/天的Mg-asp-HCl和硫酸镁(MgSO4)(1:1)。在该治疗前及治疗期间,测定了镁、钙、钾、钠、氯、肌酐和尿素以及人胎盘催乳素(HPL)和雌三醇(E3)。口服镁治疗期间,这些物质的水平没有显著变化。静脉给药后,血浆镁水平显著升高。在接下来的几周里,尽管继续治疗,镁水平仍有所下降。其他参数没有明显变化。静脉注射40毫摩尔/天的Mg-asp-HCl时,HPL的升高非常显著。如果这可以被视为胎盘功能改善的一个迹象,那么镁治疗的这种积极副作用可能对“小于胎龄”胎儿有益。建议联合使用20毫摩尔/天的Mg-asp-HCl(口服)或40毫摩尔/天的Mg-asp-HCl和MgSO4(1:1,静脉注射)。

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1
[Additional magnesium therapy in tocolysis: clinico-chemical monitoring parameters].[在宫缩抑制中额外使用镁剂治疗:临床化学监测参数]
Geburtshilfe Frauenheilkd. 1984 Jan;44(1):19-24. doi: 10.1055/s-2008-1036419.
2
[Magnesium, calcium, hemoglobin, hematocrit, estriol and human placental lactogen with magnesium substitution in pregnancy].[孕期镁替代时的镁、钙、血红蛋白、血细胞比容、雌三醇和人胎盘催乳素]
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[Cardiac parameters of the newborn after tocolysis (author's transl)].[宫缩抑制剂治疗后新生儿的心脏参数(作者译)]
Klin Padiatr. 1980 Jul;192(4):319-24. doi: 10.1055/s-2008-1035601.
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[Tocolysis with beta sympathomimetics alone or combined with the calcium antagonist verapamil? I. Effect of verapamil on maternal cardiovascular parameters and the course of pregnancy].
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Endocrinology of normal pregnancy and premature labour.正常妊娠与早产的内分泌学
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[The importance of betamimetics and magnesium for the outcome of pregnancy: I. Reduction of intrauterine growth retardation, premature rupture of membranes and premature birth after supplemental magnesium therapy].β-拟交感神经药和镁对妊娠结局的重要性:I. 补充镁治疗后减少宫内生长受限、胎膜早破和早产
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