Mason B A, Standley C A, Irtenkauf S M, Bardicef M, Cotton D B
Department of Obstetrics and Gynecology, Wayne State University/Hutzel Hospital, Detroit, MI 48201.
Am J Obstet Gynecol. 1994 Oct;171(4):999-1002. doi: 10.1016/0002-9378(94)90022-1.
Although magnesium sulfate is one of the most commonly used agents for seizure prophylaxis in preeclampsia, its efficacy relative to other anticonvulsants is incompletely investigated. The underlying mechanisms of eclamptic seizures are unknown, and there is currently no universally accepted animal model for eclampsia. However, one commonly used method for studying the relative efficacy of antiepileptic drugs is through their effect on N-methyl-D-aspartate-induced seizures. Our aim was to compare the anticonvulsant effects of phenytoin and magnesium sulfate in an N-methyl-D-aspartate-induced seizure model.
Twenty-one female rats were each stereotaxically implanted with a chronic indwelling bipolar recording electrode in the hippocampus and an injection cannula in the lateral cerebral ventricle. After 7 days animals were randomly given 90 mg/kg magnesium sulfate (n = 7), 50 mg/kg phenytoin, or saline solution (n = 7) intravenously. Fifteen minutes after the infusions animals were given 20 micrograms/microliters N-methyl-D-aspartate by direct intraventricular injection, and seizure activity was assessed for 20 minutes thereafter. All data were analyzed with the Mann-Whitney test.
When compared with saline solution controls, total duration of seizure activity in animals treated with magnesium sulfate was significantly decreased (p < 0.05) and time to onset of seizure activity was significantly increased (p < 0.05). However, rats that received phenytoin did not show significant changes in these parameters. The post-N-methyl-D-aspartate seizure mortality rate was 50% in the saline solution controls and 29% in the phenytoin group, whereas none of the rats that received magnesium sulfate died.
These results suggest that magnesium sulfate is a significantly more effective prophylactic agent than phenytoin for N-methyl-D-aspartate-induced seizures.
尽管硫酸镁是子痫前期预防惊厥最常用的药物之一,但其相对于其他抗惊厥药物的疗效尚未得到充分研究。子痫惊厥的潜在机制尚不清楚,目前尚无被普遍接受的子痫动物模型。然而,研究抗癫痫药物相对疗效的一种常用方法是通过它们对N-甲基-D-天冬氨酸诱导的惊厥的作用。我们的目的是比较苯妥英钠和硫酸镁在N-甲基-D-天冬氨酸诱导的惊厥模型中的抗惊厥作用。
21只雌性大鼠每只都通过立体定位在海马体植入慢性留置双极记录电极,并在侧脑室植入注射套管。7天后,动物被随机静脉注射90mg/kg硫酸镁(n = 7)、50mg/kg苯妥英钠或生理盐水(n = 7)。输液15分钟后,通过直接脑室内注射给动物注射20微克/微升N-甲基-D-天冬氨酸,然后评估20分钟的惊厥活动。所有数据用曼-惠特尼检验进行分析。
与生理盐水对照组相比,用硫酸镁治疗的动物惊厥活动的总持续时间显著缩短(p < 0.05),惊厥活动开始时间显著延长(p < 0.05)。然而,接受苯妥英钠的大鼠在这些参数上没有显著变化。生理盐水对照组中N-甲基-D-天冬氨酸诱导惊厥后的死亡率为50%,苯妥英钠组为29%,而接受硫酸镁的大鼠无一死亡。
这些结果表明,对于N-甲基-D-天冬氨酸诱导的惊厥,硫酸镁作为预防药物比苯妥英钠显著更有效。