目的 探讨不同宫缩抑制剂在先兆早产中的临床疗效与安全性,为先兆早产的药物治疗提供临床依据.方法 选取120例先兆早产患者作为研究对象,将其随机分为A、B、C、D四组,每组30例.A组给予盐酸利托君静滴治疗;B组给予硫酸镁静滴治疗;C组与D组分别口服消炎痛与硝苯地平治疗.比较四组患者用药后保胎效果、心率与血压及不良反应发生率.结果 四组患者间的保胎有效率、保胎成功率及孕期延长天数均具有统计学差异(χ2/F值分别为4.690、4.345、5.866,均P<0.05),以利托君组疗效最佳,硝苯地平组次之,以消炎痛组疗效最差.利托君组、硫酸镁组及硝苯地平组用药后血压与心率较用药前有明显变化(t值分别为2.042~19.883、2.469~5.163、4.230~7.766,均P<0.05),利托君组用药后心率增高幅度较大(t=19.883、19.751,均P<0.01);消炎痛组用药后血压与心率较用药前无明显变化(t值分别为0.066~0.602,均P>0.05).利托君组用药后总不良反应发生率最高,硫酸镁组次之,硝苯地平组总不良反应发生率最低,但四组间无统计学差异(χ2=3.389,P>0.05).结论 四种药物在先兆早产中的临床疗效与安全性存在一定的差异,其中硝苯地平在疗效和安全性方面均较理想.临床上应根据患者的具体情况选用药物.%Objective To study the clinical efficacy and safety of different tocolytics in the treatment of threatened preterm labor and to provide clinical evidence for drug treatment of threatened premature labor.Methods Totally 120 cases of threatened premature labor were chosen as study objects, and then they were randomly divided into group A, B, C and D with 30 cases in each group.Group A was treated with ritodrine hydrochloride by intravenous drip, group B was treated with magnesium sulfate by intravenous drip, group C and group D were orally given indomethacin and nifedipine, respectively.Fetus protection, heart rate and blood pressure were compared among four groups.Results The spuc efficient rate, spuc success rate and extended days in pregnancy among four groups had statistical difference (χ2/F value was 4.690, 4.345 and 5.866, respectively, all P<0.05).Group A had the best effect, followed by group D, and group C had the worst curative effect.Blood pressure and heart rate of group A, B and D changed significantly after the treatment (t value ranged 2.042-19.883, 2.469-5.163 and 4.230-7.766, respectively, all P<0.05).Heart rate of group A increased greatly (t value was 19.883 and 19.751, respectively, both P<0.01).The blood pressure and heart rate of group C had no significant change after treatment (t value ranged 0.066-0.602, P>0.05).Group A had the highest incidence of total adverse drug reactions, followed by group B, and group D had the lowest rate.But there was no significant difference among four groups (χ2=3.389, P>0.05).Conclusion There are some differences among four kinds of drugs in clinical efficacy and safety, and nifedipine has an ideal efficacy and safety.Drug selection in clinics should be based on the specific circumstances.
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