Kobrin I, Amodeo C, Ventura H O, Messerli F H, Frohlich E D
Am J Cardiol. 1985 Mar 1;55(6):722-5. doi: 10.1016/0002-9149(85)90144-4.
Systemic, renal and splanchnic hemodynamics and certain reflex and endocrine responses were determined in 10 patients with essential hypertension before and after intravenous administration of urapidil, a new antihypertensive agent that acts through both central and peripheral alpha-adrenergic inhibitory mechanisms. The reduction in mean arterial pressure by 12% (103 +/- 3 vs 91 +/- 6 mm Hg, p less than 0.05) was mediated through a decreased total peripheral resistance index (from 34 +/- 2 to 25 +/- 3 U/m2, p less than 0.01), which was associated with a significant reflexive increase in cardiac index, heart rate and serum norepinephrine level. This hypotensive effect was also associated with blunted Valsalva overshoot and orthostatic hypotension, suggesting peripheral arteriolar and venular dilation. Renal and splanchnic blood flows increased (p less than 0.05), resistances in these vascular beds decreased (p less than 0.01) and there were no changes in creatinine clearance or glomerular filtration fraction. Thus, intravenous urapidil reduced arterial pressure by decreasing total peripheral, renal and splanchnic resistances associated with maintained organ flows and increased heart rate and cardiac index.
在10例原发性高血压患者静脉注射新型抗高血压药物乌拉地尔前后，测定了其全身、肾脏和内脏血流动力学以及某些反射和内分泌反应。乌拉地尔通过中枢和外周α - 肾上腺素能抑制机制发挥作用。平均动脉压降低了12%（从103±3降至91±6 mmHg，p<0.05），这是通过总外周阻力指数降低介导的（从34±2降至25±3 U/m²，p<0.01），同时伴有心脏指数、心率和血清去甲肾上腺素水平显著反射性升高。这种降压作用还与瓦尔萨尔瓦动作过冲减弱和体位性低血压有关，提示外周小动脉和小静脉扩张。肾脏和内脏血流量增加（p<0.05），这些血管床的阻力降低（p<0.01），肌酐清除率或肾小球滤过分数无变化。因此，静脉注射乌拉地尔通过降低总外周、肾脏和内脏阻力来降低动脉压，同时维持器官血流量，并增加心率和心脏指数。
