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[β-1受体阻滞剂美托洛尔与宫缩抑制剂利托君联合应用对子宫胎盘血流动力学及胎儿心血管敏感性的影响,特别考虑宫内胎儿营养不良。动物实验结果]

[Effect of the combination of the beta-1-blocker metoprolol with the tocolytic fenoterol on uteroplacental hemodynamics and fetal cardiovascular sensitivity with particular consideration of intrauterine fetal malnutrition. Results of animal experiments].

作者信息

Wischnik A, Heimisch W, Wischnik B, Schroll A, Mendler N, Wieshammer E, Weidenbach A

出版信息

Arzneimittelforschung. 1982;32(11):1428-32.

PMID:6891248
Abstract

7 merino sheep in an advanced state of pregnancy received oxytocin for labour induction under the conditions of control, monotherapy with the beta 2-adrenergic tocolytic fenoterol, combination of the latter with the beta 1-blocking substance metoprolol (Beloc). Likewise, the effect of labour induction was investigated when putting an artificial stenosis around the a. uterina during simultaneous application of fenoterol alone and combined with metoprolol. The following parameters were measured: aortic pressure and heart rate both in dam and fetus, maternal left ventricular pressure rising velocity, intrauterine pressure, uterine blood flow, uterine vascular resistance and regional myometrial contraction patterns by means of an ultrasonic transit time method. Measurement of maternal cardiovascular parameters once more showed, that maternal cardiovascular derangements could excellently be antagonised by metoprolol. Intrauterine pressure measurements as well as regional myometrial contraction patterns proved evidence, that there is no counteraction between the beta 2-mimetic substance and the beta 1-blocking agent concerning the tocolytic effect. When artificially stenosing the a. uterina, a rise in uterine contraction status could be observed; this hypoxic augmentation of myometrial tone could almost completely be reverted when combining fenoterol and metoprolol. Finally, no difference could be observed in the reaction of fetal cardiovascular parameters to reduced uterine blood flow before and after application of the beta 1-blocking substance metoprolol.

摘要

7只处于妊娠晚期的美利奴绵羊在以下条件下接受催产素引产:对照组、β2 - 肾上腺素能宫缩抑制剂非诺特罗单药治疗组、后者与β1 - 阻滞剂美托洛尔(倍他乐克)联合治疗组。同样,在单独应用非诺特罗以及与美托洛尔联合应用时,通过在子宫动脉周围设置人工狭窄来研究引产效果。测量了以下参数:母羊和胎儿的主动脉压和心率、母体左心室压力上升速度、宫内压、子宫血流量、子宫血管阻力以及通过超声渡越时间法测量的局部子宫肌层收缩模式。对母体心血管参数的测量再次表明,美托洛尔能够很好地对抗母体心血管紊乱。宫内压测量以及局部子宫肌层收缩模式证明,就宫缩抑制作用而言,β2 - 拟交感物质与β1 - 阻滞剂之间不存在拮抗作用。当人工使子宫动脉狭窄时,可观察到子宫收缩状态增强;当非诺特罗与美托洛尔联合应用时,这种子宫肌层张力的缺氧性增强几乎可以完全恢复。最后,在应用β1 - 阻滞剂美托洛尔前后,胎儿心血管参数对子宫血流量减少的反应未观察到差异。

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