Scardo J A, Hogg B B, Newman R B
Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston 29425-2233, USA.
Am J Obstet Gynecol. 1995 Oct;173(4):1249-53. doi: 10.1016/0002-9378(95)91364-5.
Our purpose was to evaluate the hemodynamic effects of magnesium sulfate in preeclamptic and preterm labor patients.
Fifteen preeclamptic patients at 32.4 +/- 3.3 (mean +/- SD) weeks' gestation and 11 preterm labor patients (31.3 +/- 2.8 weeks) were hemodynamically monitored in the lateral recumbent position by thoracic electrical bioimpedance (BoMed, Irvine, Calif.) before and during high-dose magnesium sulfate bolus and infusion. Cardiac index, systemic vascular resistance index, mean arterial pressure, heart rate, and stroke index were all recorded at baseline and during magnesium sulfate infusion. All patients received a standard crystalloid infusion. Data analysis continued until the patient received epidural placement or other antihypertensive therapy or was delivered.
At baseline the systemic vascular resistance index was 2465 +/- 718 F.ohm/m2 and the cardiac index was 3.6 +/- 1.0 L/min/m2 for the preeclamptic patients. These were significantly different compared with the preterm labor patients, who had a systemic vascular resistance index of 1377 +/- 563 F.ohm/m2 and 4.6 +/- 1.2 L/min/m2. Magnesium sulfate infusion resulted in a rapid, sustained fall in systemic vascular resistance and a rise in cardiac index in the preeclamptic patient. This effect was evident at least 4 hours after initiation of the bolus and infusion. In the preterm labor patients the hemodynamic effects of magnesium sulfate were minimal and were noted only during the magnesium sulfate bolus.
Magnesium sulfate infusion appears to have a prolonged hemodynamic effect in the preeclamptic patient. Sustained reduction in systemic vascular resistance and an increase in cardiac index is found in patients with preeclampsia but not in preterm labor.
我们的目的是评估硫酸镁对先兆子痫和早产患者的血流动力学影响。
对15例妊娠32.4±3.3（均值±标准差）周的先兆子痫患者和11例早产患者（31.3±2.8周）在侧卧位时通过胸电阻抗法（BoMed，加利福尼亚州欧文市）进行血流动力学监测，监测时间为大剂量硫酸镁推注和输注前及期间。在基线和硫酸镁输注期间记录心脏指数、全身血管阻力指数、平均动脉压、心率和每搏指数。所有患者均接受标准晶体液输注。数据分析持续至患者接受硬膜外麻醉或其他降压治疗或分娩。
先兆子痫患者基线时全身血管阻力指数为2465±718 F.ohm/m²，心脏指数为3.6±1.0 L/min/m²。与早产患者相比，这些数据有显著差异，早产患者的全身血管阻力指数为1377±563 F.ohm/m²，心脏指数为4.6±1.2 L/min/m²。硫酸镁输注导致先兆子痫患者全身血管阻力迅速、持续下降，心脏指数升高。这种效应在推注和输注开始后至少4小时明显。在早产患者中，硫酸镁的血流动力学效应最小，仅在硫酸镁推注期间出现。
硫酸镁输注对先兆子痫患者似乎有持久的血流动力学效应。子痫前期患者全身血管阻力持续降低，心脏指数增加，但早产患者未出现这种情况。
