Pearl R G, Finn J C
Department of Anesthesia, Stanford University Medical Center, California 94305.
Anesth Analg. 1990 Nov;71(5):493-7. doi: 10.1213/00000539-199011000-00007.
Calcium channel blockers have been effective as pulmonary vasodilators in patients with pulmonary hypertension. The current study therefore compared the effects of prostaglandin E1, an effective pulmonary vasodilator, with the effects of the water-soluble calcium channel blocker diltiazem during pulmonary hypertension in sheep. Pulmonary hypertension was produced by continuous intravenous administration of U46619 to halothane-anesthetized sheep. Prostaglandin E1 decreased pulmonary artery pressure 29%, decreased pulmonary vascular resistance (Rp) 57%, and did not affect the ratio of pulmonary to systemic vascular resistance (Rp/Rs). Diltiazem decreased pulmonary artery pressure 15%, decreased Rp 50%, and did not affect Rp/Rs. When 0.33 mL/kg polyethylene glycol-ethanol vehicle (the vehicle used for nifedipine administration in a prior study) was administered during diltiazem infusion, pulmonary artery pressure increased 19%, Rp increased 72%, and Rp/Rs increased 29%. These results indicate that diltiazem is an effective pulmonary vasodilator and suggest that the previously reported unfavorable results of nifedipine may have been due to the vehicle used for nifedipine administration.
钙通道阻滞剂在肺动脉高压患者中作为肺血管扩张剂已显示出疗效。因此，本研究比较了有效的肺血管扩张剂前列腺素E1与水溶性钙通道阻滞剂地尔硫䓬在绵羊肺动脉高压期间的作用。通过向氟烷麻醉的绵羊持续静脉输注U46619来诱导肺动脉高压。前列腺素E1使肺动脉压降低29%，肺血管阻力（Rp）降低57%，且不影响肺血管阻力与体循环血管阻力之比（Rp/Rs）。地尔硫䓬使肺动脉压降低15%，Rp降低50%，且不影响Rp/Rs。在输注地尔硫䓬期间给予0.33 mL/kg聚乙二醇 - 乙醇溶媒（先前研究中用于硝苯地平给药的溶媒）时，肺动脉压升高19%，Rp升高72%，Rp/Rs升高29%。这些结果表明地尔硫䓬是一种有效的肺血管扩张剂，并提示先前报道的硝苯地平的不良结果可能归因于用于硝苯地平给药的溶媒。
