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纳多洛尔与比索洛尔对异丙肾上腺素诱发的人手背静脉扩张作用的比较。

Comparison of the effects of nadolol and bisoprolol on the isoprenaline-evoked dilatation of the dorsal hand vein in man.

作者信息

Abdelmawla A H, Langley R W, Szabadi E, Bradshaw C M

机构信息

Psychopharmacology Unit, Division of Psychiatry, Queen's Medical Centre, Nottingham NG7 2UH.

出版信息

Br J Clin Pharmacol. 2001 Jun;51(6):583-9. doi: 10.1046/j.0306-5251.2001.01404.x.

Abstract

AIMS

We attempted to explore the possible differential involvement of beta-adrenoceptor subtypes in the dilator response of the human dorsal hand vein to isoprenaline by examining the ability of bisoprolol, a selective beta1-adrenoceptor antagonist, and nadolol, a nonselective beta1/beta2-adrenoceptor antagonist, to antagonize the response.

METHODS

Twelve healthy male volunteers participated in four weekly sessions. In the preliminary session a dose-response curve to the vasoconstrictor effect of phenylephrine was constructed and the dose producing 50-75% maximal response was determined for each individual. In each of the remaining three (treatment) sessions, nadolol (40 mg), bisoprolol (5 mg) or placebo was ingested, and isoprenaline hydrochloride (3.33-1000 ng min(-1)) was infused locally into the dorsal hand vein along with a constant dose of phenylephrine hydrochloride (to preconstrict the vein) 2 h after the ingestion of the drugs. Changes in vein diameter were monitored with the dorsal hand vein compliance technique. Subjects were allocated to treatment session according to a double-blind balanced cross-over design. Systolic and diastolic blood pressure, and heart rate were also measured.

RESULTS

Isoprenaline produced dose-dependent venodilatation which was antagonized by nadolol but remained unaffected by bisoprolol (ANOVA with repeated measures: P < 0.025; Dunnett's test: placebo vs nadolol, P < 0.01; placebo vs bisoprolol, P = NS). Mean log ED50 (ng min-1) was significantly increased in the presence of nadolol and remained unchanged in the presence of bisoprolol (ANOVA, P < 0.025; Dunnett's test: placebo vs nadolol, P < 0.005; placebo vs bisoprolol, P = NS; differences between mean log ED50 [95% CI]: placebo vs bisoprolol -0.11 [-0.38, 0.16], placebo vs nadolol 0.32[0.09, 0.72], bisoprolol vs nadolol -0.43 [-0.71, -0.15]). Mean Emax did not differ in the three treatment conditions.

CONCLUSIONS

The failure of bisoprolol to attenuate isoprenaline-evoked venodilatation in the human dorsal hand vein argues against the involvement of a beta1-adrenoceptor-mediated component in the isoprenaline-evoked venodilatory responses. The possibility cannot be excluded that the consequences of beta1-adrenoceptor blockade by bisoprolol might have been obscured by a possible venodilator effect of bisoprolol.

摘要

目的

通过研究选择性β1肾上腺素能受体拮抗剂比索洛尔和非选择性β1/β2肾上腺素能受体拮抗剂纳多洛尔拮抗异丙肾上腺素引起的人体手背静脉扩张反应的能力,探讨β肾上腺素能受体亚型在该反应中可能的差异作用。

方法

12名健康男性志愿者参加了为期四周的四个阶段实验。在预备阶段,构建了去氧肾上腺素血管收缩作用的剂量反应曲线,并确定了每个个体产生50 - 75%最大反应的剂量。在其余三个(治疗)阶段中,分别口服纳多洛尔(40mg)、比索洛尔(5mg)或安慰剂,服药2小时后,将盐酸异丙肾上腺素(3.33 - 1000ng min⁻¹)与恒定剂量的盐酸去氧肾上腺素(用于预先收缩静脉)局部注入手背静脉。采用手背静脉顺应性技术监测静脉直径的变化。受试者按照双盲平衡交叉设计分配到各治疗阶段。同时测量收缩压、舒张压和心率。

结果

异丙肾上腺素产生剂量依赖性静脉扩张,纳多洛尔可拮抗该反应,而比索洛尔对其无影响(重复测量方差分析:P < 0.025;Dunnett检验:安慰剂对比纳多洛尔P < 0.01;安慰剂对比比索洛尔P = 无显著性差异)。在纳多洛尔存在时,平均log ED50(ng min⁻¹)显著增加,而在比索洛尔存在时保持不变(方差分析,P < 0.025;Dunnett检验:安慰剂对比纳多洛尔P < 0.005;安慰剂对比比索洛尔P = 无显著性差异;平均log ED50[95%置信区间]之间的差异:安慰剂对比比索洛尔 -0.11[-0.38, 0.16],安慰剂对比纳多洛尔0.32[0.09, 0.72],比索洛尔对比纳多洛尔 -0.43[-0.71, -0.15])。在三种治疗条件下,平均Emax无差异。

结论

比索洛尔未能减弱异丙肾上腺素引起的人体手背静脉扩张,这表明异丙肾上腺素引起的静脉扩张反应中不存在β1肾上腺素能受体介导的成分。但不能排除比索洛尔可能具有的静脉扩张作用掩盖了其对β1肾上腺素能受体的阻断作用的可能性。

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