Saadjian A Y, Philip-Joet F F, Vestri R, Arnaud A G
Department of Cardiology, Centre Hospitalo-Universitaire Nord, Marseille, France.
Eur Respir J. 1988 Aug;1(8):716-20.
This long-term controlled study was undertaken to assess the haemodynamic effects of chronic administration of Nifedipine (N). Twenty patients suffering from pulmonary hypertension secondary to chronic obstructive lung disease were divided into two groups. One group (treatment group) was instructed to take 30 mg of N daily and the other (control group) did not take N. Haemodynamic measurements were recorded before and after an 18-month observation period. For patients in the treatment group, Nifedipine was stopped 24 h prior to the second investigation. Acute response to a single dose of Nifedipine (10 mg sublingually) was also evaluated in all patients during the first and second investigations in order to estimate a possible tachyphylaxis. No significant modification in heart rate, mean pulmonary pressure, mean arterial pressure or blood gases was observed. Conversely, a 10% decrease in cardiac output (p less than 0.05) occurred in the control group. Pulmonary vascular response to acute administration of Nifedipine was the same in both groups before and after the observation period. These results suggest that while long-term administration of Nifedipine to patients with chronic obstructive lung disease does not improve pulmonary pressure, it may prevent a decrease in cardiac output. No tachyphylaxis was noted.
进行这项长期对照研究是为了评估长期服用硝苯地平（N）的血流动力学效应。20例患有慢性阻塞性肺疾病继发肺动脉高压的患者被分为两组。一组（治疗组）被要求每日服用30毫克N，另一组（对照组）不服用N。在18个月的观察期前后记录血流动力学测量值。对于治疗组患者，在第二次调查前24小时停用硝苯地平。在第一次和第二次调查期间，还对所有患者评估了单次剂量硝苯地平（10毫克舌下含服）的急性反应，以估计可能的快速耐受性。未观察到心率、平均肺动脉压、平均动脉压或血气有显著改变。相反，对照组的心输出量下降了10%（p<0.05）。观察期前后两组对急性给予硝苯地平的肺血管反应相同。这些结果表明，虽然对慢性阻塞性肺疾病患者长期服用硝苯地平不会改善肺动脉压，但可能会防止心输出量下降。未观察到快速耐受性。
