Bush A, Busst C M, Knight W B, Shinebourne E A
Department of Respiratory Physiology, Brompton Hospital, London.
Br Heart J. 1988 Aug;60(2):141-8. doi: 10.1136/hrt.60.2.141.
The haemodynamic effects of infusion of epoprostenol (prostacyclin) and bolus injection of tolazoline were compared in a crossover study in 11 children with pulmonary hypertension caused by pulmonary vascular disease. The children were studied during cardiac catheterisation, while they were anaesthetised, paralysed, and ventilated with 100% oxygen. The order of drug administration was not randomised because tolazoline has a half life of hours whereas epoprostenol has a half life of a few minutes. Both drugs caused pulmonary and systemic vasodilatation, and there were no significant differences between the two. The 95% confidence intervals suggest that tolazoline did not have a clinically important haemodynamic advantage over epoprostenol. Previous reports suggest that serious side effects are common when tolazoline is used in repeated doses; epoprostenol has only a few minor side effects that are rapidly reversible when the infusion is stopped. Epoprostenol is more expensive than tolazoline but this study suggests that epoprostenol is a more suitable pulmonary vasodilator if more than a single dose is required.
在一项交叉研究中，对11名因肺血管疾病导致肺动脉高压的儿童输注依前列醇（前列环素）和推注妥拉唑啉的血流动力学效应进行了比较。这些儿童在心脏导管插入术期间接受研究，当时他们处于麻醉、麻痹状态，并用100%氧气进行通气。给药顺序未随机化，因为妥拉唑啉的半衰期为数小时，而依前列醇的半衰期为几分钟。两种药物均引起肺血管和体循环血管扩张，两者之间无显著差异。95%置信区间表明，妥拉唑啉在血流动力学方面相对于依前列醇没有临床上重要的优势。先前的报告表明，重复使用妥拉唑啉时严重副作用很常见；依前列醇只有少数轻微副作用，停止输注后可迅速逆转。依前列醇比妥拉唑啉更昂贵，但这项研究表明，如果需要不止一剂，依前列醇是更合适的肺血管扩张剂。
