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硫酸吗啡对人体冠状动脉血流的影响。

Effects of morphine sulfate on human coronary blood flow.

作者信息

Leaman D M, Nellis S H, Zelis R, Field J M

出版信息

Am J Cardiol. 1978 Feb;41(2):324-6. doi: 10.1016/0002-9149(78)90173-x.

Abstract

Because morphine causes coronary vasoconstriction in conscious dogs, human coronary blood flow was measured with the thermodilution technique before and after administration of morphine sulfate, 0.2 mg/kg body weight (maximum 15 mg) intravenously, in 10 patients to determine if the canine experience is clinically applicable. Coronary blood flow increased from a baseline value of 104.4 +/- 13.4 (mean +/- standard error of the mean) to 113.0 +/- 17.4 ml/min (difference not significant) 15 minutes after the administration of morphine. Baseline coronary vascular resistance was 1.14 +/- 0.19 mm Hg/ml/min; 15 minutes after morphine administration the resistance value was 1.02 +/- 0.17 (P less than 0.025). There was no significant change between baseline values and values 15 minutes after morphine administration in systemic mean arterial pressure (98.2 +/- 5.3 to 92.8 +/- 4.7 mm Hg); heart rate (69.5 +/- 3.5 to 72.6 +/- 3.4 beats/min), left ventricular ejection time (0.345 +/- 0.009 to 0.342 +/- 0.007 second) or tension-time index (2,324 +/- 128 to 2,291 +/- 149 mm Hg/sec per min). The slight coronary vasodilation noted after morphine administration in this study is in marked contrast to the significant coronary vasoconstriction demonstrated in the unanesthetized dog.

摘要

由于吗啡可使清醒犬的冠状动脉收缩,因此对10例患者静脉注射0.2mg/kg体重(最大剂量15mg)硫酸吗啡前后,采用热稀释技术测量其冠状动脉血流量,以确定犬的实验结果是否适用于临床。注射吗啡15分钟后,冠状动脉血流量从基线值104.4±13.4(平均值±平均标准误差)增加至113.0±17.4ml/分钟(差异不显著)。基线冠状动脉血管阻力为1.14±0.19mmHg/ml/分钟;注射吗啡15分钟后,阻力值为1.02±0.17(P<0.025)。全身平均动脉压(从98.2±5.3至92.8±4.7mmHg)、心率(从69.5±3.5至72.6±3.4次/分钟)、左心室射血时间(从0.345±0.009至0.342±0.007秒)或张力-时间指数(从2324±128至2291±149mmHg/秒/分钟)在注射吗啡前的基线值与15分钟后的数值之间均无显著变化。本研究中观察到的吗啡注射后轻微的冠状动脉血管舒张与未麻醉犬中显示的显著冠状动脉血管收缩形成鲜明对比。

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