Zannad F, Voisin P, Sadoul N, Marchal C, Donetti C, Stoltz J F, Gilgenkrantz J M
Département de Pharmacologie clinique, CHRU de Nancy, Hôpital central.
Arch Mal Coeur Vaiss. 1987 Jun;80(6):844-50.
In arterial hypertension, hyperviscosity with hemorheological disturbances and platelet dysfunction may play a role in the prognosis and complications of the disease. We studied the effects of Nicardipine (NIC) on these blood disturbances in a group of 21 untreated patients with essential hypertension, aged 25 to 70 years (SBP/DBP = 185 +/- 28/105 +/- 17 mmHg). During one hour before and 4 hours after the IV injection of single doses of 5, 7.5 or 10 mg NIC over 5 min, blood pressure was recorded automatically (Dinamap). Hemorheological variables and platelet function were studied before and 30 min, 3 h and 24 hours after the injection. NIC lowered blood pressure and increased heart rate significantly (At 5 min, SBP = -24 mmHg; DBP = -18 mmHg; HR = +22 b/min). These effects were dose-dependent with rapid onset and short duration (less than 2 hrs). NIC decreased plasma viscosity from 1.36 +/- 0.08 to 1.30 +/- 0.07 Cst; p less than 0.01, whole blood viscosity from 22.4 +/- 2.8 to 20.7 +/- 1.5 mPas; p less than 0.05 for gamma = 0.512 s-1, and erythrocyte filterability with the Ca++ ionophore A 23187 from 16.3 +/- 3.8 to 13.5 +/- 3.1; p less than 0.01. Platelet aggregation with ADP was unchanged, but aggregation with A 23187 decreased from 46.9 +/- 21.2 to 31.3 +/- 25.6; p less than 0.05, as well as plasma levels of beta-thromboglobulin (71.2 +/- 29.8 to 55.4 +/- 24.3 ng/ml; p less than 0.02) and platelet generated malonaldehyde (7.2 +/- 1.8 to 6.7 +/- 1.4 nM/10(9) platelets; NS).(ABSTRACT TRUNCATED AT 250 WORDS)
在动脉高血压中，血液流变学紊乱导致的高黏滞性和血小板功能障碍可能在该疾病的预后和并发症中起作用。我们研究了尼卡地平（NIC）对21例未经治疗的原发性高血压患者（年龄25至70岁，收缩压/舒张压 = 185±28/105±17 mmHg）血液紊乱的影响。在静脉注射单剂量5、7.5或10 mg NIC（5分钟内注射完毕）前1小时和注射后4小时，自动记录血压（Dinamap）。在注射前以及注射后30分钟、3小时和24小时研究血液流变学变量和血小板功能。尼卡地平显著降低血压并增加心率（5分钟时，收缩压 = -24 mmHg；舒张压 = -18 mmHg；心率 = +22次/分钟）。这些作用呈剂量依赖性，起效迅速且持续时间短（小于2小时）。尼卡地平使血浆黏度从1.36±0.08降至1.30±0.07厘斯；p<0.01，全血黏度在γ = 0.512秒-1时从22.4±2.8降至20.7±1.5毫帕秒；p<0.05，以及用钙离子载体A 23187处理后的红细胞滤过率从16.3±3.8降至13.5±3.；p<0.01。用二磷酸腺苷（ADP）诱导的血小板聚集未改变，但用A 23187诱导的聚集从46.9±21.2降至31.3±25.6；p<0.05，以及β-血小板球蛋白的血浆水平（从71.2±29.8降至55.4±24.3 ng/ml；p<0.02）和血小板产生的丙二醛（从7.2±1.8降至6.7±1.4 nM/10⁹血小板；无显著差异）。（摘要截短于250字）
