Scholz M, Kneissl G D, Dieterich H A, Kaltenbach M, Bussmann W D
Abteilung für Kardiologie des Klinikums, Johann Wolfgang Goethe Universität, Frankfurt.
Z Kardiol. 1991;80 Suppl 4:69-74.
The acute effects of enoximone (E) and captopril (C) were compared in a single-blind, randomized, cross-over trial in 10 patients (P) (nine with dilative cardiomyopathy, one with coronary heart disease) with heart failure (NYHA Class III: 6P and Class IV:4P). Cardiac index (Cl, 1/min.nm(-2), mean pulmonary artery pressure (PAM, mmHg), and pulmonary capillary wedge pressure (PC, mmHg) were measured at baseline and 15, 30, and 60 min after 0.1 mg/kg C and 0.75 mg/kg E, respectively, followed by measurements at 15, 30, 60, 180, and 300 min after 0.2 mg/kg C and 1,5 mg/kg E, respectively.
Cl was unchanged 60 min after 0.1 mg/kg C, increased 60 min after 0.2 mg/kg C by 7.7% from 2.1 +/- 0.5 to 2.4 +/- 0.5 (p = 0,001), and was unchanged after 5 h. Cl increased 60 min after 0.75 mg/kg E by 32.5% from 2.1 +/- 0.5 to 2.9 +/- 0.4 (p = 0.001), 60 min after 1,5 mg/kg E by 59% to 3.3 +/- 0.6 (p = 0,001), and after 5 h by 19% to 2.5 +/- 0.4 (p = 0.01). PAM was unchanged 60 min after 0.1 mg/kg C, decreased 60 min after 0.2 mg/kg C by 10% from 35.7 +/- 11 to 31.7 +/- 10, and was unchanged after 5 h. PAM decreased 60 min after 0.75 mg/kg E by 13% from 35 +/- 9 to 31 +/- 10 (p = 0.01), 60 min after 1.5 mg/kg E by 19% from 35 +/- 9 to 27 +/- 9 (p = 0.001), and was unchanged after 5 h. PC decreased 60 min after 0.1 mg/kg C by 23% from 24 +/- 8 to 19 +/- 9 (p = 0.05) and was unchanged 60 min und 5 h after 0.2 mg/kg C. PC decreased 60 min after 0.75 mg/kg E by 35% from 25 +/- 6 to 17 +/- 8 (p = 0,01) and 60 min after 1.5 mg/kg E by 47% to 14 +/- 8 (p = 0,001) and was unchanged after 5 h.
The clinical trial showed that in P with chronic heart failure (NYHA III and IV) the acute increase of Cl and decrease of PC is higher after E than after C. The improvement of hemodynamics lasts longer after i.v. E than i.v.C.
在一项单盲、随机、交叉试验中，对10例心力衰竭患者（9例扩张型心肌病患者，1例冠心病患者）（纽约心脏协会III级：6例，IV级：4例）比较了依诺昔酮（E）和卡托普利（C）的急性效应。在基线以及分别给予0.1mg/kg C和0.75mg/kg E后15、30和60分钟测量心脏指数（CI，升/分钟·平方米）、平均肺动脉压（PAM，毫米汞柱）和肺毛细血管楔压（PC，毫米汞柱），随后分别在给予0.2mg/kg C和1.5mg/kg E后15、30、60、180和300分钟进行测量。
给予0.1mg/kg C后60分钟CI无变化，给予0.2mg/kg C后60分钟CI从2.1±0.5升高7.7%至2.4±0.5（p = 0.001），5小时后无变化。给予0.75mg/kg E后60分钟CI从2.1±0.5升高32.5%至2.9±0.4（p = 0.001），给予1.5mg/kg E后60分钟升高59%至3.3±0.6（p = 0.001），5小时后升高19%至2.5±0.4（p = 0.01）。给予0.1mg/kg C后60分钟PAM无变化，给予0.2mg/kg C后60分钟PAM从35.7±11降低10%至31.7±10，5小时后无变化。给予0.75mg/kg E后60分钟PAM从35±9降低13%至31±10（p = 0.01），给予1.5mg/kg E后60分钟降低19%至27±9（p = 0.001），5小时后无变化。给予0.1mg/kg C后60分钟PC从24±8降低23%至19±9（p = 0.05），给予0.2mg/kg C后60分钟及5小时后无变化。给予0.75mg/kg E后60分钟PC从25±6降低35%至17±8（p = 0.01），给予1.5mg/kg E后60分钟降低47%至14±8（p = 0.001），5小时后无变化。
该临床试验表明，在慢性心力衰竭（纽约心脏协会III级和IV级）患者中，依诺昔酮使CI急性升高和PC降低的幅度高于卡托普利。静脉注射依诺昔酮后血流动力学改善持续时间长于静脉注射卡托普利。
