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[硝苯地平诱发低血压时的颅内压及颅内顺应性变化]

[The behavior of intracranial pressure and intracranial compliance in nifedipine-induced hypotension].

作者信息

Anger C, Wüsten R, Woulters P, Van Aken H, Heinecke A, Lawin P

机构信息

Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin, Westfälischen Wilhelms-Universität Münster.

出版信息

Anasth Intensivther Notfallmed. 1988 Dec;23(6):303-8.

PMID:3239729
Abstract

The influence of nifedipine induced hypotension on intracranial pressure (ICP) and intracranial compliance (ICC) was investigated in dogs without (group I, n = 8) and with (group II, n = 8) intracranial hypertension. ICP in group II was raised by gradual inflation of an epidurally placed balloon catheter. A volume-pressure-response curve (VPR) was established before and during the administration of nifedipine. In group II dogs angiotensin was infused before and during infusion of nifedipine in a dose sufficient to raise mean arterial pressure (MAP) by 30-40 mm Hg. An infusion of nifedipine (2 micrograms X kg-1 X min-1) subsequent to a bolus injection of nifedipine (10 micrograms X kg-1) resulted in a significant and sustained decrease in MAP (p less than 0.05) by 25% and 35% resp. due to a significant reduction in total peripheral resistance (p less than 0.05). ICP increased from 8.7 +/- 3.0 mm Hg to a maximum of 12.5 +/- 5.2 mm Hg in group I animals (p less than 0.05) and from 19.8 +/- 2.6 mm Hg to 24.8 +/- 7.2 mm Hg not significantly in group II dogs. The pressure-volume-index revealed a slight reduction of ICC in group I and a slight increase of ICC in group II resp. during nifedipine as compared to before nifedipine. When angiotensin was being administered in group II dogs before nifedipine was given, MAP increased by 40 +/- 5.8 mm Hg while ICP did not change significantly (+2 +/- 2.4 mm Hg).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在没有颅内高压(I组,n = 8)和有颅内高压(II组,n = 8)的犬中,研究了硝苯地平诱导的低血压对颅内压(ICP)和颅内顺应性(ICC)的影响。II组的ICP通过硬膜外放置的球囊导管逐渐充气升高。在给予硝苯地平之前和期间建立容量-压力反应曲线(VPR)。在II组犬中,在输注硝苯地平之前和期间以足以使平均动脉压(MAP)升高30 - 40 mmHg的剂量输注血管紧张素。在推注硝苯地平(10μg/kg)后输注硝苯地平(2μg·kg⁻¹·min⁻¹)导致MAP分别显著且持续降低25%和35%(p < 0.05),这是由于总外周阻力显著降低(p < 0.05)。I组动物的ICP从8.7±3.0 mmHg升高至最高12.5±5.2 mmHg(p < 0.05),II组犬的ICP从19.8±2.6 mmHg升高至24.8±7.2 mmHg,升高不显著。压力-容量指数显示,与硝苯地平给药前相比,I组ICC略有降低,II组ICC略有升高。当在II组犬给予硝苯地平之前给予血管紧张素时,MAP升高40±5.8 mmHg,而ICP无显著变化(+2±2.4 mmHg)。(摘要截短于250字)

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