Eliasen K, Ringsted C, Munck O, Hjortsø E, Heslet L
Department of Anaesthesia, University of Copenhagen, Herlev Hospital, Denmark.
Clin Physiol. 1991 May;11(3):231-43. doi: 10.1111/j.1475-097x.1991.tb00454.x.
Twenty patients with a median age of 61 years and a median forced expired volume in 1 s (FEV1) after bronchodilating therapy of 0.55 l were studied in order to measure the effect of intravenous terbutaline on bronchial tone, cardiac function, pulmonary haemodynamics, gas exchange, and oxygen transport capacity during rest and in 10 patients during exercise. Terbutaline infusion during rest resulted in an increase in heart rate from 84 to 103 beats min-1 (P less than 0.01), a decrease in mean systemic arterial pressure from 95 to 80 mmHg (P less than 0.02), an unchanged mean pulmonary arterial pressure (18 mmHg), an increase in cardiac index from 2.89 to 3.86 l min-1 m-2 (P less than 0.01), an increase in right ventricular ejection fraction from 45 to 53% (P less than 0.01), an increase in left ventricular ejection fraction from 63 to 67% (NS), an unchanged arterial oxygen tension, and an increase in calculated oxygen delivery from 533 to 638 ml O2 min-1 m-2 (P less than 0.01). During exercise terbutaline infusion resulted in an increase in heart rate from 108 to 120 beats min-1 (P less than 0.05), a decrease in mean systemic arterial pressure from 117 to 106 mmHg (P less than 0.01), a decrease in mean pulmonary arterial pressure from 29 to 22 mmHg (P less than 0.01), an increase in cardiac index from 4.53 to 4.64 min-1 m-2 (NS), an unchanged arterial oxygen tension, and an increase in the calculated oxygen delivery from 834 to 856 ml O2 min-1 m-2 (NS). It was concluded that terbutaline augments right ventricular function: increases right ventricular ejection fraction and decreases right ventricular end-diastolic volume, and further decreases pulmonary vascular resistance without decreasing arterial oxygen tension, and increases oxygen delivery in patients with chronic pulmonary disease during rest and exercise.
对20名患者进行了研究，这些患者的中位年龄为61岁，支气管扩张治疗后1秒用力呼气容积（FEV1）的中位数为0.55升，目的是测量静脉注射特布他林在静息状态下以及10名患者运动时对支气管张力、心功能、肺血流动力学、气体交换和氧输送能力的影响。静息状态下输注特布他林导致心率从84次/分钟增加到103次/分钟（P<0.01），平均体循环动脉压从95 mmHg降至80 mmHg（P<0.02），平均肺动脉压不变（18 mmHg），心脏指数从2.89升·分钟-1·米-2增加到3.86升·分钟-1·米-2（P<0.01），右心室射血分数从45%增加到53%（P<0.01），左心室射血分数从63%增加到67%（无统计学意义），动脉血氧张力不变，计算得出的氧输送量从533毫升O2·分钟-1·米-2增加到638毫升O2·分钟-1·米-2（P<0.01）。运动时输注特布他林导致心率从108次/分钟增加到120次/分钟（P<0.05），平均体循环动脉压从117 mmHg降至106 mmHg（P<0.01），平均肺动脉压从29 mmHg降至22 mmHg（P<0.01），心脏指数从4.53升·分钟-1·米-2增加到4.64升·分钟-1·米-2（无统计学意义），动脉血氧张力不变，计算得出的氧输送量从834毫升O2·分钟-1·米-2增加到856毫升O2·分钟-1·米-2（无统计学意义）。得出的结论是，特布他林可增强右心室功能：增加右心室射血分数并减少右心室舒张末期容积，进一步降低肺血管阻力而不降低动脉血氧张力，并增加慢性肺病患者在静息和运动时的氧输送量。
