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利美尼定对原发性高血压患者动脉参数的影响

[Effects of rilmenidine on arterial parameters in essential arterial hypertension].

作者信息

Pannier B, Safar M

机构信息

Hôpital Broussais, Paris.

出版信息

Arch Mal Coeur Vaiss. 1989 Dec;82 Spec No 5:47-51.

PMID:2517009
Abstract

Rilmenidine (RIL) is a new antihypertensive agent which lowers sympathetic tone, so reducing systemic peripheral resistance. The effects of a single dose of RIL (1 mg) on arterial function were the object of a preliminary randomised double-blind versus placebo trial in 14 patients with hypertension after a one month washout period on placebo. The following parameters were recorded before (T0) and 4 hours after administration (T4): blood pressure, heart rate (automatic recordings), diameter of the humeral artery (D), mean blood flow velocity (Vm) by an 8 MHz duplex pulsed Doppler system, local forearm resistances (LR = mean BP/D2 Vm/4), carotid-femoral pulse wave velocity (PWV) and humeral arterial wall tension (mean BP.D/2). The two groups were compared by statistical analysis of variance with two crossed factors. RIL significantly lowered systolic BP (p less than 0.02), diastolic BP (p less than 0.05) and mean BP (p less than 0.01) without changing the heart rate. The D and PWV were unchanged in the RIL group. There was a significant improvement in arterial wall tension (-6.7% vs + 1.1%; p = 0.02) associated with a tendency to increase the PWV (45% vs 4%; p = 0.097) and to decrease LR (46% vs 10%; p = 0.062) although those changes were not statistically significant compared with those observed with placebo. These initial results indicate that the hypotensive effect of RIL is accompanied by a reduction in humeral arterial wall tension which occurs without any change in arterial diameter. This also reflects a change in the pressure-volume relationship with RIL.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

利美尼定(RIL)是一种新型抗高血压药物,它可降低交感神经张力,从而降低全身外周阻力。在14例高血压患者经过一个月的安慰剂洗脱期后,进行了一项初步随机双盲对照安慰剂试验,研究单剂量利美尼定(1毫克)对动脉功能的影响。在给药前(T0)和给药后4小时(T4)记录以下参数:血压、心率(自动记录)、肱动脉直径(D)、通过8兆赫双功能脉冲多普勒系统测量的平均血流速度(Vm)、局部前臂阻力(LR =平均血压/D²Vm/4)、颈股脉搏波速度(PWV)和肱动脉壁张力(平均血压·D/2)。通过双因素方差分析对两组进行比较。利美尼定显著降低收缩压(p<0.02)、舒张压(p<0.05)和平均血压(p<0.01),而心率未改变。利美尼定组的D和PWV未改变。动脉壁张力有显著改善(-6.7%对+1.1%;p = 0.02),同时PWV有增加趋势(45%对4%;p = 0.097),LR有降低趋势(46%对10%;p = 0.062),尽管与安慰剂组相比这些变化无统计学意义。这些初步结果表明,利美尼定的降压作用伴随着肱动脉壁张力的降低,且动脉直径无任何变化。这也反映了利美尼定作用下压力-容积关系的改变。(摘要截选至250字)

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