HEMODYNAMIC-EFFECTS OF INTRAVENOUS COCAINE ON THE PREGNANT EWE AND FETUS
HEMODYNAMIC-EFFECTS OF INTRAVENOUS COCAINE ON THE PREGNANT EWE AND FETUS
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DOI：
10.1016/s0002-9378(86)80044-8
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发表时间：
1986-10-01
影响因子：
9.8
通讯作者：
RESNIK, R
中科院分区：
文献类型：
--
作者：
MOORE, TR;SORG, J;RESNIK, R
可卡因是一种有效的血管收缩剂，目前是广泛滥用药物的对象。由于对妊娠期可卡因的生理反应知之甚少，因此研究了静脉注射可卡因对子宫血流量以及其他母体和胎儿心血管参数的影响。 8只妊娠晚期母羊在双侧子宫动脉周围安装电磁流量探头，并在母体和胎儿的下腔静脉和主动脉放置导管。按母体体重 0.5 和 1.0 mg/kg 进行静脉推注可达到峰值血浆可卡因水平，与滥用药物后在人类受试者中观察到的水平相似（平均水平 = 229 至 400 ng/ml，n=8）。推注 0.5 或 1.0 mg/kg 可卡因后，母亲平均动脉压分别增加 32% 和 37% (p < 0.005)。服用 0.5 毫克/公斤可卡因后，胎儿血压上升 12.6%。这些可卡因输注在 15 分钟内使子宫血流量显着减少 36% 和 42% (p < 0.005)。对母体儿茶酚胺反应的分析表明，输注可卡因后血浆去甲肾上腺素水平显着升高（210%）。这些研究表明，当可卡因以产生在人类中观察到的血浆水平的剂量施用时，可显着降低子宫血流量持续≥15分钟，同时诱发怀孕母羊和胎儿的高血压反应。
Cocaine is a potent vasoconstrictive agent that is currently the subject of widespread drug abuse. Because little is known of the physiologic responses to cocaine in pregnancy, the effects of intravenous cocaine on uterine blod flow and other maternal and fetal cardiovascular parameters were studied. Eight ewes in late pregnancy were equipped with electromagnetic flow probes around both uterine arteries and catheters were placed in the maternal and fetal inferior vena cavae and aortas. Bolus intravenous infusion of 0.5 and 1.0 mg/kg of maternal body weight achieved peak plasma cocaine levels similar to those observed in human subjects after abuse of the drug (mean level = 229 to 400 ng/ml, n=8). After bolus infusion of 0.5 or 1.0 mg/kg of cocaine, mean maternal arterial pressure increased 32% and 37%, respectively (p < 0.005). Fetal blood pressure rose 12.6% after a dosage of 0.5 mg/kg of cocaine. These cocaine infusions significantly decreased uterine blood flow by 36% and 42% for a duration of 15 minutes (p < 0.005). Analysis of maternal catecholamine responses demonstrated a significant (210%) rise in plasma norephinephrine levels after cocaine infusion. These studies demonstrate that cocaine, when administered in doses that produce plasma levels observed in humans, significantly decreases uterine blood flow for a duration of .gtoreq.15 minutes while inducing a hypertensive response in the pregnant ewe and fetus.