Ogilvie R I, Zborowska-Sluis D
Clinical Pharmacology Service, Toronto Hospital (Western Division), Ontario, Canada.
J Cardiovasc Pharmacol. 1991 Oct;18(4):574-80. doi: 10.1097/00005344-199110000-00014.
To determine whether changes in vascular capacitance induced by nitroglycerin (NTG) and nitroprusside were due to changes in compliance or unstressed vascular volume, doses producing similar reductions in arterial pressure (Psa) were studied on separate days in six dogs anesthetized and ventilated with pentobarbital after splenectomy during ganglion blockade with hexamethonium. Mean circulatory filling pressure (Pmcf) was determined during transient circulatory arrest induced by acetylcholine at baseline blood volumes and after increases of 5 and 10 ml/kg. Central blood volumes (CBVs, pulmonary artery to aortic root) were determined from transit times, and separately measured cardiac output (CO) was estimated by thermodilution (right atrium to pulmonary artery). NTG and nitroprusside produced similar reductions in Psa and Pmcf without significantly altering right atrial pressure (Pra), pressure gradient for venous return, or CO. Total vascular compliance was not altered, but total vascular capacitance was increased on an average of 4.0 +/- 1.4 ml/kg after NTG and 3.0 +/- 1.3 ml/kg after nitroprusside by increases in unstressed volume. Both drugs caused a variable reduction in CBV, averaging 2 ml/kg. Thus, both drugs produced a large increase in peripheral venous capacitance by increasing unstressed vascular volume without altering total vascular compliance.
为了确定硝酸甘油(NTG)和硝普钠引起的血管容量变化是由于顺应性改变还是无应力血管容量改变,在六只经脾切除并用戊巴比妥麻醉和通气的狗中,于六甲铵进行神经节阻滞期间,在不同日期研究了产生相似动脉压(Psa)降低的剂量。在基线血容量以及增加5和10 ml/kg后,通过乙酰胆碱诱导的短暂循环骤停期间测定平均循环充盈压(Pmcf)。根据通过时间确定中心血容量(CBV,肺动脉至主动脉根部),并通过热稀释法(右心房至肺动脉)单独测量估计心输出量(CO)。NTG和硝普钠使Psa和Pmcf产生相似的降低,而未显著改变右心房压力(Pra)、静脉回流压力梯度或CO。总血管顺应性未改变,但无应力容量增加使总血管容量在NTG后平均增加4.0±1.4 ml/kg,在硝普钠后平均增加3.0±1.3 ml/kg。两种药物均使CBV出现不同程度的降低,平均为2 ml/kg。因此,两种药物均通过增加无应力血管容量而使外周静脉容量大幅增加,而未改变总血管顺应性。