Hayase S, Yano Y, Ogawa K, Akita T, Koike A, Kidokoro H, Hattori T
Kyobu Geka. 1989 Mar;42(3):189-94.
The hemodynamic effects of combined therapy utilizing sodium nitroprusside (SNP) and nitroglycerin (TNG) were compared with those of TNG therapy in patients who underwent coronary artery bypass grafting (CABG). Of 58 patients who received catecholamine infusion to maintain hemodynamics after CABG, 17 had perioperative myocardial infarction (PMI (+) cases) and the other 41 had not PMI (PMI (-) cases). 26 of 41 patients (PMI (-) cases) received nitroglycerin therapy (NTG group) and the other 15 patients received combined therapy (SNP + NTG group). 11 of 17 patients (PMI (+) cases) received NTG therapy and the other 6 patients received combined therapy. The hemodynamic valuables, which were studied, were as follows; cardiac index, stroke volume index, left ventricular stroke work index, systemic vascular resistance index, pulmonary vascular resistance index, and deep core temperature. SNP + TNG group revealed significantly lower systemic vascular resistance index and pulmonary vascular resistance index than TNG group in PMI (-) cases. In PMI (+) cases, SNP + TNG group revealed significantly higher cardiac index, stroke volume index, left ventricular stroke work index, and significantly lower pulmonary vascular resistance index than TNG group. These findings demonstrate that combined therapy can obtain more secure vasodilation than TNG therapy.
在接受冠状动脉旁路移植术（CABG）的患者中，比较了硝普钠（SNP）和硝酸甘油（TNG）联合治疗与TNG治疗的血流动力学效应。在58例CABG术后接受儿茶酚胺输注以维持血流动力学的患者中，17例发生围手术期心肌梗死（PMI（+）组），另外41例未发生PMI（PMI（-）组）。41例患者中的26例（PMI（-）组）接受硝酸甘油治疗（NTG组），另外15例患者接受联合治疗（SNP + NTG组）。17例患者中的11例（PMI（+）组）接受NTG治疗，另外6例患者接受联合治疗。所研究的血流动力学指标如下：心脏指数、每搏量指数、左心室每搏功指数、全身血管阻力指数、肺血管阻力指数和深部体温。在PMI（-）组中，SNP + TNG组的全身血管阻力指数和肺血管阻力指数显著低于TNG组。在PMI（+）组中，SNP + TNG组的心脏指数、每搏量指数、左心室每搏功指数显著高于TNG组，肺血管阻力指数显著低于TNG组。这些结果表明，联合治疗比TNG治疗能获得更可靠的血管舒张效果。
