Ueda K, Sakai M, Matsushita S, Kuwajima I, Murakami M
Jpn Heart J. 1983 Sep;24(5):711-21. doi: 10.1536/ihj.24.711.
We studied the hemodynamic response to orally administered hydralazine (30 mg) and examined the changes in neurohumoral factors in 16 aged patients with chronic congestive heart failure. After a single 30 mg dose, 9 patients (Group I) demonstrated a greater than 30% decrease in systemic vascular resistance (SVR) and a significant increase in the cardiac index (CI); 7 patients, whose SVR was decreased by less than 30% (Group II), showed a less marked increase in CI. After 3 days of drug administration (90 mg/day), the CI decreased in Group I (p less than 0.05) while it tended to increase further in Group II. Pretreatment plasma norepinephrine was lower in Group I than Group II (p less than 0.05). However, in Group I, it increased after 3 days of therapy, with a concomitant increase in plasma renin activity (p less than 0.01) and total plasma volume (P less than 0.025). We conclude that the higher pretreatment plasma norepinephrine level in Group II, suggestive of more severe derangement of left ventricular function, may be associated with a less pronounced dilatory response of the peripheral vasculature after a single dose of hydralazine, and that the increase in norepinephrine in Group I after 3 days of treatment may limit these patients' late hemodynamic responses to the drug.
我们研究了口服肼屈嗪（30毫克）后的血流动力学反应，并检测了16例老年慢性充血性心力衰竭患者神经体液因子的变化。单次服用30毫克剂量后，9例患者（第一组）的体循环血管阻力（SVR）下降超过30%，心脏指数（CI）显著升高；7例患者（第二组）的SVR下降不到30%，CI升高不明显。给药3天（90毫克/天）后，第一组的CI下降（p<0.05），而第二组的CI则有进一步升高的趋势。第一组治疗前血浆去甲肾上腺素水平低于第二组（p<0.05）。然而，在第一组中，治疗3天后其水平升高，同时血浆肾素活性（p<0.01）和血浆总量（P<0.025）也随之升高。我们得出结论，第二组治疗前较高的血浆去甲肾上腺素水平提示左心室功能紊乱更严重，这可能与单次服用肼屈嗪后外周血管舒张反应不明显有关，而且第一组治疗3天后去甲肾上腺素的升高可能会限制这些患者后期对该药的血流动力学反应。
