Gordon M C, Iams J D
Ohio State University, Columbus, USA.
Clin Obstet Gynecol. 1995 Dec;38(4):706-12. doi: 10.1097/00003081-199538040-00005.
Since the first American report on the use of magnesium sulfate tocolysis in 1977, its popularity as a tocolytic agent has increased progressively. Primarily because of its safety and familiarity, magnesium has become the primary tocolytic agent in the majority of U.S. centers. The exact mechanism of action is unknown, and long-term effects on neonates have not been studied. Although randomized studies show similar success compared to other tocolytic agents, no placebo-controlled study has shown neonatal improvement with magnesium sulfate tocolysis. This is similar to the studies of beta-sympathomimetic tocolytics and has led some authors (e.g., Higby) to suggest that safe dosages of magnesium sulfate are ineffective in preventing preterm birth and should not be used as a tocolytic agent. Although magnesium sulfate, like other tocolytics, has not fulfilled the initial promise of preventing preterm birth, it does appear if used correctly in a well identified population of patients to at least transiently inhibit preterm labor as well as other tocolytic agents with fewer side effects and fewer contraindications.
自1977年美国首次报道使用硫酸镁进行宫缩抑制以来，其作为宫缩抑制剂的应用逐渐增多。主要因其安全性和人们对它的熟悉程度，镁已成为美国大多数医疗中心主要的宫缩抑制剂。其确切作用机制尚不清楚，对新生儿的长期影响也未得到研究。尽管随机研究表明与其他宫缩抑制剂相比成功率相似，但尚无安慰剂对照研究显示硫酸镁宫缩抑制可改善新生儿情况。这与β-拟交感神经类宫缩抑制剂的研究情况类似，并导致一些作者（如希格比）认为安全剂量的硫酸镁在预防早产方面无效且不应作为宫缩抑制剂使用。尽管硫酸镁与其他宫缩抑制剂一样，未实现预防早产这一最初的承诺，但在明确界定的患者群体中正确使用时，它似乎至少能像其他宫缩抑制剂一样短暂抑制早产宫缩，且副作用更少、禁忌更少。
