Renard M, Liebens I, Waterschoot P, Bernard R
Angiology. 1986 Sep;37(9):633-41. doi: 10.1177/000331978603700903.
Intravenous clonidine was used to treat systolic hypertension (systolic blood pressure greater than 160 mm Hg) in 15 patients with acute myocardial infarction and documented sympathetic overactivity (high plasma norepinephrine). Its effects on haemodynamics and blood gases were studied. After one hour, clonidine significantly reduced the systolic (195 +/- 7 to 137 +/- 7 mm Hg, p less than 0.01) and diastolic (81 +/- 4 to 60 +/- 3 mm Hg, p less than 0.01) blood pressures as well as the systemic vascular resistance (26 +/- 2 to 20 +/- 1 IU, p less than 0.01). The cardiac index was reduced from 2.8 +/- 0.2 to 2.4 +/- 0.2 l/min X m2, p less than 0.01. This change was related to a reduction of the heart rate (92 +/- 4 to 81 +/- 4 beats/min, p less than 0.01) as the stroke index was unchanged. Pulmonary wedge pressure (15 +/- 3 to 10 +/- 2 mm Hg, p less than 0.01) and rate pressure product (18.034 +/- 1.159 to 11.274 +/- 917 mm Hg, beats/min, p less than 0.01) were also significantly decreased. The arterial oxygen tension did not change significantly but there was a significant drop in the mixed venous oxygen saturation (63 +/- 2 to 61 +/- 2%, p less than 0.02) and oxygen transport (433 +/- 41 to 409 +/- 36, p less than 0.01). Clonidine is thus able to normalize blood pressure in acute myocardial infarction; this is accompanied by a reduction in myocardial oxygen requirements and pulmonary wedge pressure. Oxygen transport to the tissues, however, may be decreased.
静脉注射可乐定用于治疗15例急性心肌梗死且有交感神经过度活跃（血浆去甲肾上腺素水平高）记录的患者的收缩期高血压（收缩压大于160 mmHg）。研究了其对血流动力学和血气的影响。1小时后，可乐定显著降低了收缩压（从195±7 mmHg降至137±7 mmHg，p<0.01）和舒张压（从81±4 mmHg降至60±3 mmHg，p<0.01）以及全身血管阻力（从26±2 IU降至20±1 IU，p<0.01）。心脏指数从2.8±0.2降至2.4±0.2 l/min·m²，p<0.01。这种变化与心率降低有关（从92±4次/分钟降至81±4次/分钟，p<0.01），因为每搏指数未改变。肺楔压（从15±3 mmHg降至10±2 mmHg，p<0.01）和速率压力乘积（从18034±1159 mmHg·次/分钟降至11274±917 mmHg·次/分钟，p<0.01）也显著降低。动脉血氧张力无显著变化，但混合静脉血氧饱和度有显著下降（从63±2%降至61±2%，p<0.02）和氧输送（从433±41降至409±36，p<0.01）。因此，可乐定能够使急性心肌梗死患者的血压正常化；这伴随着心肌需氧量和肺楔压的降低。然而，组织的氧输送可能会减少。
