Thys D M, Sivak G, Kaplan J A
Am Heart J. 1985 Jul;110(1 Pt 2):273-6. doi: 10.1016/0002-8703(85)90500-9.
Intravenous nitroglycerin (NTG) has recently been found to be useful for the control of blood pressure during the perioperative period, especially during coronary artery bypass procedures. The objective of this study was to determine whether intravenous isosorbide dinitrate (ISDN) could play a similar role. Sixty-seven patients undergoing coronary artery bypass grafting at three centers were randomly assigned to an ISDN or NTG treatment group. The hemodynamic performance of all patients was assessed by the methods commonly used for cardiac patients (ECG, arterial line, thermodilution pulmonary artery catheter). One of the two nitrates was infused whenever the systolic blood pressure or the pulmonary capillary wedge pressure exceeded predetermined values. Treatment by either agent was considered successful if the elevated values returned to normal. NTG reduced the blood pressure in a higher percentage of hypertensive events. The rates of success were 84% for NTG vs 72% for ISDN in the prebypass phase, 93% vs 64% in the postbypass phase, and 71% vs 54% in the postoperative phase. Increased ISDN effectiveness may be attained with the use of a bolus administration before continuous infusion or with the use of a rapid rate of infusion.
静脉注射硝酸甘油（NTG）最近被发现可用于围手术期血压控制，尤其是在冠状动脉搭桥手术期间。本研究的目的是确定静脉注射硝酸异山梨酯（ISDN）是否能发挥类似作用。在三个中心接受冠状动脉搭桥手术的67例患者被随机分配至ISDN或NTG治疗组。所有患者的血流动力学表现通过常用于心脏病患者的方法（心电图、动脉导管、热稀释肺动脉导管）进行评估。每当收缩压或肺毛细血管楔压超过预定值时，就输注两种硝酸盐中的一种。如果升高的值恢复正常，则认为两种药物的治疗均成功。在较高比例的高血压事件中，NTG降低了血压。在搭桥前阶段，NTG的成功率为84%，而ISDN为72%；在搭桥后阶段，分别为93%和64%；在术后阶段，分别为71%和54%。在持续输注前使用推注给药或使用快速输注速率可能会提高ISDN的有效性。
