Morgan J M, McCormack D G, Griffiths M J, Morgan C J, Barnes P J, Evans T W
Department of Thoracic Medicine, Royal Brompton and National Heart Hospital, London, UK.
Circulation. 1991 Sep;84(3):1145-9. doi: 10.1161/01.cir.84.3.1145.
The acute administration of vasodilator drugs to patients with primary pulmonary hypertension has been advocated to identify those with reversible pulmonary vasoconstriction. Unfortunately, the usefulness of the drugs currently available is limited by accompanying systemic hypotension. A vasodilator with effects confined to the pulmonary circulation would therefore be advantageous in such patients.
The purine nucleoside adenosine was infused into the pulmonary artery in seven patients with primary pulmonary hypertension (baseline pulmonary vascular resistance [PVR], 442-1,295 dyne/cm/sec-5) to determine its effect on PVR. In all patients, there was a dose-dependent and significant reduction (mean maximal percent decrease from baseline, 38.9%; p less than 0.001) in PVR mediated through a decrease in pulmonary artery pressure and an increase in cardiac output. Systemic vascular resistance (SVR) also decreased, but the ratio of PVR to SVR decreased (maximal mean percent decrease from baseline) by 10.5% (p less than 0.025), indicating that adenosine has a preferential vasodilator effect on the pulmonary circulation when administered in this manner.
Because of its pharmacokinetic and vasodilator properties, adenosine may have a specific role in the investigation of primary pulmonary hypertension.
有人主张对原发性肺动脉高压患者急性给予血管扩张剂药物，以识别那些存在可逆性肺血管收缩的患者。不幸的是，目前可用药物的有效性受到伴随的全身性低血压的限制。因此，一种作用局限于肺循环的血管扩张剂对这类患者将是有利的。
将嘌呤核苷腺苷注入7例原发性肺动脉高压患者（基线肺血管阻力[PVR]，442 - 1295达因/厘米/秒 - 5）的肺动脉，以确定其对PVR的影响。在所有患者中，通过肺动脉压降低和心输出量增加介导，PVR出现剂量依赖性且显著降低（平均最大百分比下降幅度相对于基线为38.9%；p < 0.001）。全身血管阻力（SVR）也降低，但PVR与SVR的比值降低（相对于基线的最大平均百分比下降）了10.5%（p < 0.025），表明以这种方式给药时，腺苷对肺循环具有优先的血管扩张作用。
由于其药代动力学和血管扩张特性，腺苷在原发性肺动脉高压的研究中可能具有特定作用。
