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[卡托普利对扩张型心肌病患儿的血流动力学影响]

[Hemodynamic effect of captopril in children with dilated cardiomyopathy].

作者信息

Stern H, Genz T, Emmrich P, Bühlmeyer K

机构信息

Pädiatrische Kardiologie, Deutsches Herzzentrum, München, Bundesrepublik Deutschaland.

出版信息

Wien Klin Wochenschr. 1988 Dec 16;100(24):814-8.

PMID:3070967
Abstract

Hemodynamic effects of captopril were prospectively studied in 12 children suffering from dilative cardiomyopathy. Before the administration of the drug all patients were put on a stable medication of diuretics and/or glycosides. A median daily dose of 1.83 mg captopril/kg body weight was given in 3 or 4 single doses depending on age. Median body weight of the children was 18.6 kg (range 2.7-42.2) and the median age was 5.8 years (range 0.2-15). Left ventricular volume was determined in systole and diastole using 2-D echo, and the stroke volume als well as the ejection fraction were calculated. Cardiac index (CI) and systemic resistance (Rs) were measured by Doppler echo. Blood pressure and heart rate were recorded at each echo registration. ESVI (-32%), EDVI (-21%) and SVI (-7%) were significantly (p less than 0.05) reduced by short-term captopril treatment. This effect was maintained under long-term therapy. EF, CI, Rs, blood pressure and heart rate showed only minor changes under captopril. Adverse effects were recorded only in one child. They disappeared after dose reduction.

摘要

对12例扩张型心肌病患儿进行了卡托普利血流动力学效应的前瞻性研究。在给药前,所有患者均服用稳定剂量的利尿剂和/或强心苷。根据年龄,卡托普利的日剂量中位数为1.83 mg/kg体重,分3或4次单剂量给药。患儿的体重中位数为18.6 kg(范围2.7 - 42.2),年龄中位数为5.8岁(范围0.2 - 15)。使用二维超声心动图测定收缩期和舒张期左心室容积,并计算每搏输出量和射血分数。通过多普勒超声心动图测量心脏指数(CI)和全身血管阻力(Rs)。每次超声心动图检查时记录血压和心率。短期卡托普利治疗可使左心室收缩末期容积指数(ESVI,降低32%)、舒张末期容积指数(EDVI,降低21%)和每搏量指数(SVI,降低7%)显著降低(p < 0.05)。这种效果在长期治疗中得以维持。卡托普利治疗下,射血分数、心脏指数、全身血管阻力、血压和心率仅有轻微变化。仅1例患儿记录到不良反应。剂量减少后不良反应消失。

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