Holleboom C A, Merkus J M, van Elferen L W, Keirse M J
Department of Obstetrics and Gynaecology, Maria Hospital, Tilburg, The Netherlands.
Br J Obstet Gynaecol. 1993 Dec;100(12):1107-10. doi: 10.1111/j.1471-0528.1993.tb15174.x.
To develop a ritodrine infusion scheme for preterm labour that avoids plasma levels above those needed for tocolysis, requires only one rate adjustment, and is easy to apply in practice.
Prospective study of tocolytic effect and plasma ritodrine concentrations during application of the infusion scheme.
High risk labour ward.
Consecutive series of 31 women in labour at less than 36 weeks' gestation.
Loading dose ritodrine infusion followed, as soon as tocolysis is reached, by a decrease in the infusion rate calculated on the basis of the interval between start of treatment and tocolysis.
Overall, steady state ritodrine levels were nearly identical to those at the time of tocolysis and correlated well with levels anticipated on the basis of our calculation (n = 30; r = 0.91; P < 0.001). Adjustments during steady state were made in 12 women (40%), but in only two of them within 12 h after tocolysis had been reached. Delivery was postponed for more than 48 h in 29 women (93.5%) and beyond 37 weeks' gestation in 19 (61.3%).
The loading model is easy to apply, avoids relative overdoses, requires few adjustments, is well tolerated, uses smaller quantities of ritodrine, and results in lower plasma ritodrine concentrations than the conventional infusion scheme.
制定一种用于早产的利托君输注方案，该方案可避免血浆水平高于宫缩抑制所需水平，仅需一次速率调整，且易于在实际中应用。
在应用输注方案期间对宫缩抑制效果和血浆利托君浓度进行前瞻性研究。
高危产科病房。
连续纳入31例孕周小于36周的临产妇女。
先给予负荷剂量的利托君输注，一旦达到宫缩抑制，根据治疗开始至宫缩抑制的间隔时间计算降低输注速率。
总体而言，利托君稳态水平与宫缩抑制时的水平几乎相同，且与我们计算预期的水平相关性良好（n = 30；r = 0.91；P < 0.001）。12例妇女（40%）在稳态期间进行了调整，但其中只有2例是在达到宫缩抑制后12小时内进行的。29例妇女（93.5%）分娩推迟超过48小时，19例（61.3%）超过37周妊娠。
与传统输注方案相比，负荷模型易于应用，可避免相对过量，调整次数少，耐受性好，使用的利托君量少，且血浆利托君浓度更低。
