Scott J P, Higenbottam T, Wallwork J
Department of Respiratory Physiology, Papworth Hospital, Cambridge.
Br J Clin Pract. 1990 Jun;44(6):231-4.
Twelve patients with severe primary pulmonary hypertension and pronounced disability unresponsive to oral vasolidators were assessed as to their suitability for heart-lung transplantation. During routine right heart catheterisation, intravenous infusions of both prostacyclin (PG1(2] and its synthetic analogue, iloprost (IL), were given in random order. The dose of each drug was increased whilst the improvements in cardiac output (Q) and pulmonary vascular resistance (PVR) were recorded. The maximum rate of each infusion was determined by the onset of side effects or a fall in mean systemic blood pressure of more than 20 per cent. The mean maximum dose of PG1(2) was 6 +/- 2 ng/kg/min and that of IL 3.4 +/- 1.8 ng/kg/min, and both infusions achieved similar haemodynamic effects. In this open, randomised study, intravenous IL was as effective as prostacyclin in lowering PVR, but with a lower infused dose. Iloprost may have an important role in the acute assessment of patients with primary pulmonary hypertension, and when available for prescription should be assessed as an alterative long-term intravenous vasodilator to prostacyclin.
对12例重度原发性肺动脉高压且对口服血管扩张剂无反应、功能严重受限的患者进行了心肺移植适用性评估。在常规右心导管插入术期间，随机顺序静脉输注前列环素（PGI₂）及其合成类似物依洛前列素（IL）。每种药物的剂量增加，同时记录心输出量（Q）和肺血管阻力（PVR）的改善情况。每次输注的最大速率由副作用的出现或平均体循环血压下降超过20%来确定。PGI₂的平均最大剂量为6±2 ng/kg/min，IL的平均最大剂量为3.4±1.8 ng/kg/min，两种输注均产生了相似的血流动力学效应。在这项开放性随机研究中，静脉注射IL在降低PVR方面与前列环素一样有效，但输注剂量较低。依洛前列素在原发性肺动脉高压患者的急性评估中可能具有重要作用，当可用于处方时，应作为前列环素的替代长期静脉血管扩张剂进行评估。
