Fowler N O, Holmes J C, Gaffney T E, Privitera P J, Grupp G
J Clin Invest. 1970 Nov;49(11):2036-50. doi: 10.1172/JCI106423.
Our studies demonstrated that phenoxybenzamine, 10 mg/kg, administered intravenously to intact anesthetized dogs, produced an immediate and significant increase of heart rate and cardiac output. In heart-lung preparations, phenoxybenzamine had no effect or a negative cardiac inotropic effect, hence these actions were not related to direct cardiac action or to release of myocardial norepinephrine stores. Serial estimations of arterial blood catecholamines after phenoxybenzamine showed an increase of epinephrine and norepinephrine; the peak values of these catecholamines did not correlate well with the maximum cardiac output responses. Ganglionic blockade largely eliminated the early cardiac effects of phenoxybenzamine, hence its action did not appear to be upon peripheral terminals of postganglionic sympathetic or parasympathetic nerves. Phenoxybenzamine was found to have antivagal actions which might account for some of the delayed cardiac acceleration. When beta adrenergic receptor blockade was induced by sotalol, the cardiac effects of phenoxybenzamine were largely eliminated. Baroreceptor denervation prevented the increase of cardiac output after phenoxybenzamine. These observations are consistent with the concept that the increase of cardiac rate and output produced by phenoxybenzamine is principally mediated by baroreceptor reflexes acting through sympathetic cardiac nerves or circulating catecholamines.
我们的研究表明,给完整的麻醉犬静脉注射10mg/kg的酚苄明,会使心率和心输出量立即显著增加。在心肺制备物中,酚苄明没有作用或有负性心肌收缩力作用,因此这些作用与直接的心脏作用或心肌去甲肾上腺素储存的释放无关。酚苄明给药后对动脉血儿茶酚胺的系列测定显示肾上腺素和去甲肾上腺素增加;这些儿茶酚胺的峰值与最大心输出量反应的相关性不佳。神经节阻断在很大程度上消除了酚苄明的早期心脏效应,因此其作用似乎并非作用于节后交感或副交感神经的外周末梢。发现酚苄明具有抗迷走神经作用,这可能是一些延迟性心脏加速的原因。当索他洛尔诱导β肾上腺素能受体阻断时,酚苄明的心脏效应在很大程度上被消除。压力感受器去神经支配可防止酚苄明给药后心输出量增加。这些观察结果与以下概念一致,即酚苄明引起的心率和心输出量增加主要是由通过交感心脏神经或循环儿茶酚胺起作用的压力感受器反射介导的。