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[ISH2010]妊娠高血压治疗策略——L.Magee教授专访

作者:国际循环网   日期:2010/10/11 11:42:00

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<International Circulation>:OK Professor Magee, you briefly covered this in you presentation, but, and you mentioned the ACE inhibitors being contraindicated, this included Captipril and Alipril, and so on

    <International Circulation>:Magnesium sulfate is preferred for pregnancy hypertension but its therapeutic concentration is close to its toxic dose. Is it necessary to routinely test magnesium concentration and if toxicity occurs how should it be treated?

 《国际循环》:我想谈谈硫酸镁,其治疗妊娠高血压的治疗浓度与中毒浓度很接近。那是否需要对其进行常规的血药浓度监测?如何纠正其毒副反应。

    Prof.L.Magee:The Magpie trial used a 4g loading dose and 1g/hr without monitoring serum magnesium levels. In this multicenter trial conducted in both well resourced and poorly resourced settings this was shown to be safe. Therefore, we do not need to monitor serum magnesium levels unless we have some reason to believe that there may be accumulation. For example, in women with underlying impaired renal function then serum magnesium levels can be tested. If there is toxicity, the antidote is 1g of calcium gluconate, which is readily available.

    Magee教授:多中心、优劣试验条件的Magpie 试验证实了给予硫酸镁4mg初始负荷剂量及每小时追加1mg给药剂量是安全的,虽并未监测血清镁的浓度。因此我们不需要对其进行血药浓度监测,除非它有蓄积作用。比如,若一个孕妇出现肾功能不全,虽然没有蛋白尿,但其肾功能是受损的,此时必须监测血清镁浓度,若出现镁中毒可以用葡萄糖酸钙进行解毒治疗,而且葡萄糖酸钙是用于产妇分娩的必备药物。

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妊娠高血压ACE抑制剂治疗策略L.Magee教授

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