Lejeune P, Leeman M, Mélot C, Naeije R
Dept of Intensive Care, Erasme University Hospital, Brussels, Belgium.
Eur Respir J. 1989 Apr;2(4):370-6.
In the literature, it remains uncertain whether methylxanthines inhibit hypoxic pulmonary vasoconstriction. We examined the effects of theophylline and of S 9795, a new methylxanthine derivative, on multipoint mean pulmonary arterial pressure (Ppa)/cardiac index (Q) relationships in 31 intact dogs, ventilated alternately in hyperoxia (fraction of inspired oxygen, FIO2 0.4) and in hypoxia (FIO2 0.1). A sequence of two 5-point Ppa/Q plots at FIO2 0.4 and at FIO2 0.1, consecutively, was performed before and after i.v. administrations of theophylline 10 mg.kg-1 (n = 8) and 25 mg.kg-1 (n = 7), of S 9795 10 mg.kg-1 (n = 8) and of placebo (n = 8). The Ppa/Q plots were rectilinear in all experimental conditions. Over the entire range of Q studied, 2-5 l.min-1.m-2, hypoxia increased Ppa in all animals. Placebo had no effect on these Ppa/Q plots. Theophylline at the lowest dose (plasma levels from 8.4-13.6 micrograms.ml-1) and S 9795 (plasma levels from 3.0-11.2 micrograms.ml-1) did not affect Ppa/Q in hyperoxia or in hypoxia. Theophylline at the highest dose (plasma levels from 17.8-40.4 micrograms.ml-1) reduced hypoxic Ppa at all levels of Q and hyperoxic Ppa at the highest Q, from 3-5 l.min-1.m-2, and inhibited hypoxia-induced increases in Ppa. We conclude that pulmonary vasoconstriction may be preserved after the lowest doses of methylxanthines recommended for the treatment of increased bronchial tone.
在文献中,甲基黄嘌呤是否抑制低氧性肺血管收缩仍不确定。我们研究了氨茶碱和一种新的甲基黄嘌呤衍生物S 9795对31只完整犬的多点平均肺动脉压(Ppa)/心指数(Q)关系的影响,这些犬在高氧(吸入氧分数,FIO2 0.4)和低氧(FIO2 0.1)下交替通气。在静脉注射10 mg.kg-1(n = 8)和25 mg.kg-1(n = 7)的氨茶碱、10 mg.kg-1(n = 8)的S 9795和安慰剂(n = 8)之前和之后,连续进行一系列在FIO2 0.4和FIO2 0.1时的两点5点Ppa/Q图。在所有实验条件下,Ppa/Q图均为直线。在所研究的整个Q范围内,2 - 5 l.min-1.m-2,低氧使所有动物的Ppa升高。安慰剂对这些Ppa/Q图无影响。最低剂量的氨茶碱(血浆水平为8.4 - 13.6微克/毫升)和S 9795(血浆水平为3.0 - 11.2微克/毫升)在高氧或低氧时均不影响Ppa/Q。最高剂量的氨茶碱(血浆水平为17.8 - 40.4微克/毫升)在所有Q水平下降低低氧性Ppa,并在最高Q值(3 - 5 l.min-1.m-2)时降低高氧性Ppa,并抑制低氧诱导的Ppa升高。我们得出结论,在推荐用于治疗支气管张力增加的最低剂量甲基黄嘌呤后,肺血管收缩可能得以保留。