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氨茶碱对清醒犬心脏功能及局部血流分布的作用与作用机制

Effects and mechanism of action of aminophylline on cardiac function and regional blood flow distribution in conscious dogs.

作者信息

Rutherford J D, Vatner S F, Braunwald E

出版信息

Circulation. 1981 Feb;63(2):378-87. doi: 10.1161/01.cir.63.2.378.

DOI:10.1161/01.cir.63.2.378
PMID:6108802
Abstract

The effects of aminophylline, 1 mg/kg/min infused intravenously for 10 minutes, were examined on left ventricular (LV) diameter, pressure, an indexes of myocardial contractility, as well as systemic, coronary and regional hemodynamics in conscious dogs. Aminophylline increased mean arterial pressure 12 +/- 2%, LV systolic pressure 8 +/- 1%, LV dP/dt 20 +/- 2%, velocity of myocardial fiber shortening 13 +/- 2% and heart rate 5 +/- 2%, and reduced LV end-diastolic diameter 2 +/- 0.5%. Vascular resistance rose in the systemic bed 13 +/- 5%, the coronary bed 26 +/- 3%, the mesenteric bed 26 +/- 5% and the iliac bed 36 +/- 4%, but did not rise in the renal bed. Both beta-adrenergic receptor blockade with propranolol and chronic treatment with reserpine attentuated but did not abolish the positive inotropic response induced by aminophylline. Alpha-adrenergic receptor blockade with phentolamine prevented aminophylline-induced vasoconstriction in the systemic, coronary, mesenteric and iliac beds. In contrast to the vasoconstriction with i.v. aminophylline, when the drug was infused directly into the iliac artery, it elicited marked iliac vasodilation. Thus, in the intact conscious dog, i.v. aminophylline, in a dose that had little effect on heart rate, increased LV contractility and reduced preload. The increase in contractility was dependent in part on intact beta-adrenergic nervous activity and endogenous catecholamine stores. The increase in systemic, coronary, iliac and mesenteric resistances involved alpha-adrenergic mechanisms. These actions appear to involve autonomic mechanisms, because the only direct effect of aminophylline on the iliac artery was marked vasodilation.

摘要

研究了静脉注射氨茶碱(1毫克/千克/分钟,持续10分钟)对清醒犬左心室(LV)直径、压力、心肌收缩性指标以及全身、冠状动脉和局部血流动力学的影响。氨茶碱使平均动脉压升高12±2%,左心室收缩压升高8±1%,左心室dP/dt升高20±2%,心肌纤维缩短速度升高13±2%,心率升高5±2%,并使左心室舒张末期直径降低2±0.5%。全身血管床阻力升高13±5%,冠状动脉床阻力升高26±3%,肠系膜床阻力升高26±5%,髂床阻力升高36±4%,但肾床阻力未升高。普萘洛尔对β-肾上腺素能受体的阻断以及利血平的长期治疗减弱但并未消除氨茶碱诱导的正性肌力反应。酚妥拉明对α-肾上腺素能受体的阻断可防止氨茶碱在全身、冠状动脉、肠系膜和髂床引起的血管收缩。与静脉注射氨茶碱引起的血管收缩相反,当将该药物直接注入髂动脉时,可引起明显的髂动脉血管舒张。因此,在完整的清醒犬中,静脉注射氨茶碱在对心率影响较小的剂量下,可增加左心室收缩性并降低前负荷。收缩性的增加部分依赖于完整的β-肾上腺素能神经活动和内源性儿茶酚胺储备。全身、冠状动脉、髂动脉和肠系膜阻力的增加涉及α-肾上腺素能机制。这些作用似乎涉及自主神经机制,因为氨茶碱对髂动脉的唯一直接作用是明显的血管舒张。

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