Fahmy N R, Gavras H P
J Cardiovasc Pharmacol. 1985 Sep-Oct;7(5):869-74. doi: 10.1097/00005344-198509000-00009.
The impact of oral captopril, 2 mg . kg-1, on the dose and on the hemodynamic and hormonal effects of nitroprusside was studied in seven patients (Group II). A comparable group (Group I, n = 7) received nitroprusside alone. In both groups, nitroprusside produced comparable decreases in mean arterial pressure, systemic vascular resistance, and right atrial pressure; cardiac output increased because of a significant change in heart rate. Although plasma renin activity increased significantly (compared with control values) in both groups, it was greater (p = 0.01) through the operative period in patients pretreated with captopril. Plasma aldosterone concentration increased in Group I (p = 0.01) but decreased in Group II (p = 0.01). Plasma catecholamine concentrations increased (p = 0.01) with nitroprusside alone but were unchanged in captopril-treated patients. Plasma converting enzyme activity was markedly inhibited (p = 0.001) by captopril. Following cessation of nitroprusside infusion in Group I, rebound hypertension occurred in conjunction with a significant (p = 0.01) increase in systemic vascular resistance; it was associated with elevated plasma renin activity, catecholamines, and aldosterone concentrations. In contrast, captopril-treated patients showed no rebound hemodynamic changes. Nitroprusside dose was less (p = 0.01) with captopril pretreatment (2.1 +/- 0.3 vs. 4.8 +/- 0.9 microgram . kg-1 . min-1). Thus, captopril is a useful adjunct to nitroprusside-induced hypotension.
研究了口服卡托普利（2毫克·千克⁻¹）对硝普钠剂量以及血流动力学和激素效应的影响，共纳入7例患者（第二组）。设立了一个对照可比组（第一组，n = 7），该组仅接受硝普钠治疗。两组中，硝普钠均使平均动脉压、全身血管阻力和右心房压力出现了类似程度的下降；由于心率发生显著变化，心输出量增加。虽然两组的血浆肾素活性均显著升高（与对照值相比），但在手术期间，接受卡托普利预处理的患者其血浆肾素活性更高（p = 0.01）。第一组的血浆醛固酮浓度升高（p = 0.01），而第二组降低（p = 0.01）。单独使用硝普钠时血浆儿茶酚胺浓度升高（p = 0.01），但接受卡托普利治疗的患者血浆儿茶酚胺浓度未发生变化。卡托普利显著抑制了血浆转换酶活性（p = 0.001）。在第一组停止输注硝普钠后，出现了反弹性高血压，同时全身血管阻力显著增加（p = 0.01）；这与血浆肾素活性、儿茶酚胺和醛固酮浓度升高有关。相比之下，接受卡托普利治疗的患者未出现反弹性血流动力学变化。卡托普利预处理后硝普钠剂量减少（p = 0.01）（2.1±0.3与4.8±0.9微克·千克⁻¹·分钟⁻¹）。因此，卡托普利是硝普钠诱导低血压的有用辅助药物。
