Král B, Hamet A, Cernohorský D, Stásek J, Pospísil M, Tilser P, Eliás J, Havel V, Strasová A, Koudelka V
2nd Department of Medicine, Medical Faculty, Charles University, Hradec Králové.
Sb Ved Pr Lek Fak Karlovy Univerzity Hradci Kralove. 1990;33(3):223-95.
The authors investigated the influence of some vasodilatory drugs on pulmonary and systemic haemodynamic parameters in 69 patients with pulmonary hypertension secondary to chronic obstructive pulmonary disease (with the exception of two patients with diffuse pulmonary fibrosis and one patient with recurrent pulmonary thromboembolism). The investigated vasodilatory drugs were as follows: Dihydralazine Spofa--8 patients, Corinfar--10 patients, Ketanserin--13 patients, Nit-Ret 7 patients, Nitroglycerin Spofa--10 patients, Nitro-Mack--11 patients, Iso-Mack retard--10 patients. The haemodynamic parameters were measured before and at various time intervals after the administration of the vasodilatory agent (Dihydralazine 50 mg perorally--30th and 60th minute, Corinfar--20 mg sublingually--60th minute, and in 7 patients following a 6 months period of 30-60 mg Corinfar daily dose, Ketanserin--10 mg intravenously--10th, 20th and 40th minute, Nit-Ret--2.5 mg perorally--30th and 60th minute, Nitroglycerin Spofa--0.5 mg sublingually--10th and 30th minute, Nitro-Mack--1 mg intravenously--immediately following the end of a slow i. v. infusion for 20 minutes, Iso-Mack retard--20 mg perorally, 60th minute). The blood gases were measured at the same time intervals, too. The results in various groups were as follows: Dihydralazine administration was not followed by any significant change in PAP, CO, PVR, while a significant decrease in AOP and SVR was ascertained. A significant decrease of PaCO2 and no change in PaO2 were measured. Following Corinfar administration, no change in PAP, CO or PVR and a significant decrease of PaCO2 and no change in PaO2 were measured. Following Corinfar administration, no change in PAP, CO or PVR and a significant decrease in AOP were determined. No significant changes in blood gases were measured. Following a 6 month Corinfar treatment period in 7 subjects, no significant changes in pulmonary haemodynamics or blood gases values were found. No clinical benefit of this drug could be estimated. Ketanserin administration was not followed by any changes in pulmonary haemodynamics, whereas a significant decrease in AOP and SVR were found. The administration of Nit-Ret was followed by a significant decrease of CO, whereas no changes in PAP, AOP or PVR and SVR were found. No significant changes in the blood gas tenses values were measured. The administration of Nitroglycerin Spofa was followed by a significant decrease in RAP, PAP, AOP, RVEDP as well as in CO. No significant changes in blood gases were observed. The application of 1 mg Nitro-Mack intravenously was followed by a significant decrease in RAP, PAP, AOP and CO.(ABSTRACT TRUNCATED AT 400 WORDS)
作者研究了某些血管舒张药物对69例慢性阻塞性肺疾病所致肺动脉高压患者（不包括2例弥漫性肺纤维化患者和1例复发性肺血栓栓塞患者）肺和全身血流动力学参数的影响。所研究的血管舒张药物如下：捷克斯洛伐克制药厂生产的双肼屈嗪——8例患者；可立斯丁——10例患者；酮色林——13例患者；硝异梨醇控释片——7例患者；捷克斯洛伐克制药厂生产的硝酸甘油——10例患者；麦新同——11例患者；长效异乐定——10例患者。在给予血管舒张剂之前及之后的不同时间间隔测量血流动力学参数（口服50mg双肼屈嗪——第30和60分钟；舌下含服20mg可立斯丁——第60分钟，7例患者每日剂量30 - 60mg可立斯丁治疗6个月后；静脉注射10mg酮色林——第10、20和40分钟；口服2.5mg硝异梨醇控释片——第30和60分钟；舌下含服0.5mg捷克斯洛伐克制药厂生产的硝酸甘油——第10和30分钟；静脉注射1mg麦新同——静脉缓慢输注20分钟结束后立即测量；口服20mg长效异乐定——第60分钟）。同时在相同时间间隔测量血气。各小组的结果如下：服用双肼屈嗪后，肺动脉压（PAP）、心输出量（CO）、肺血管阻力（PVR）无显著变化，而主动脉压（AOP）和体循环血管阻力（SVR）显著降低。测得动脉血二氧化碳分压（PaCO₂）显著降低，动脉血氧分压（PaO₂）无变化。服用可立斯丁后，PAP、CO或PVR无变化，PaCO₂显著降低，PaO₂无变化。服用可立斯丁后，PAP、CO或PVR无变化，AOP显著降低。血气无显著变化。7例受试者接受6个月可立斯丁治疗后，肺血流动力学或血气值无显著变化。无法评估该药物的临床益处。服用酮色林后肺血流动力学无变化，而AOP和SVR显著降低。服用硝异梨醇控释片后CO显著降低，而PAP、AOP或PVR以及SVR无变化。血气张力值无显著变化。服用捷克斯洛伐克制药厂生产的硝酸甘油后，右房压（RAP）、PAP、AOP、右室舒张末期压（RVEDP）以及CO均显著降低。血气无显著变化。静脉注射1mg麦新同后，RAP、PAP、AOP和CO显著降低。（摘要截于400字）
