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静脉注射可乐定可降低眼压并改变眼内血流。

Intravenous administration of clonidine reduces intraocular pressure and alters ocular blood flow.

作者信息

Weigert Günther, Resch Hemma, Luksch Alexandra, Reitsamer Herbert A, Fuchsjager-Mayrl Gabriele, Schmetterer Leopold, Garhofer Gerhard

机构信息

Department of Clinical Pharmacology, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.

出版信息

Br J Ophthalmol. 2007 Oct;91(10):1354-8. doi: 10.1136/bjo.2007.116574. Epub 2007 May 30.

Abstract

AIM

To evaluate the effect of intravenously administered clonidine on ocular blood flow in healthy volunteers.

METHODS

A randomised, double-masked, placebo-controlled, two-way crossover study was performed in 12 healthy young volunteers. Clonidine (0.2 microg/kg/min) or placebo was administered intravenously over 10 minutes. The effects of clonidine were studied at baseline and up to 150 minutes after infusion. Ocular haemodynamics were measured using laser Doppler flowmetry, laser Doppler velocimetry and a retinal vessel analyser.

RESULTS

Clonidine significantly decreased mean arterial pressure (MAP) and intraocular pressure (IOP). Calculated ocular perfusion pressure decreased significantly by -8.7+/-8.7% after infusion of clonidine (p<0.01 vs placebo). Retinal arterial diameters increased by +4.4+/-2.7% (p = 0.012 vs placebo), whereas no significant change was observed in retinal veins. Red blood cell velocity decreased by -16+/-14% (p<0.01 vs placebo) after infusion of clonidine. Hence, calculated retinal blood flow decreased by -14+/-12% (p = 0.033 vs placebo). Choroidal blood flow increased by +18+/-19% (p<0.01 vs placebo) and optic nerve head blood flow increased by +16+/-23% (p = 0.046 vs placebo) 30 minutes after administration of clonidine but both returned to baseline thereafter.

CONCLUSION

The short-time increase in choroidal and optic nerve head blood flow indicates a transient vasodilatory effect of clonidine due to an unknown mechanism. The decrease in retinal blood flow indicates clonidine-induced vasoconstriction in the retinal microvasculature.

摘要

目的

评估静脉注射可乐定对健康志愿者眼部血流的影响。

方法

对12名健康年轻志愿者进行了一项随机、双盲、安慰剂对照的双向交叉研究。可乐定(0.2微克/千克/分钟)或安慰剂静脉输注10分钟。在基线及输注后长达150分钟研究可乐定的作用。使用激光多普勒血流仪、激光多普勒测速仪和视网膜血管分析仪测量眼部血流动力学。

结果

可乐定显著降低平均动脉压(MAP)和眼压(IOP)。输注可乐定后,计算得出的眼灌注压显著降低-8.7±8.7%(与安慰剂相比,p<0.01)。视网膜动脉直径增加+4.4±2.7%(与安慰剂相比,p = 0.012),而视网膜静脉未观察到显著变化。输注可乐定后,红细胞速度降低-16±14%(与安慰剂相比,p<0.01)。因此,计算得出的视网膜血流量降低-14±12%(与安慰剂相比,p = 0.033)。可乐定给药30分钟后脉络膜血流量增加+18±19%(与安慰剂相比,p<0.01),视神经乳头血流量增加+16±23%(与安慰剂相比,p = 0.046),但此后两者均恢复至基线水平。

结论

脉络膜和视神经乳头血流量的短期增加表明可乐定通过未知机制产生短暂的血管舒张作用。视网膜血流量的降低表明可乐定引起视网膜微脉管系统血管收缩。

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