Rubin L J, Lazar J D
J Clin Invest. 1983 May;71(5):1366-74. doi: 10.1172/jci110889.
To determine whether the pulmonary vasodilation produced by isoproterenol is mediated solely by its beta adrenergic effects, we studied the hemodynamic responses to isoproterenol in three groups of dogs with pulmonary vasoconstriction produced by continuous ventilation with 10% oxygen: (a) hypoxia alone, (b) hypoxia and propranolol 0.3 mg/kg i.v. bolus followed by an infusion of 5 micrograms/kg per min, and (c) hypoxia after pretreatment with an inhibitor of cyclooxygenase, either indomethacin or meclofenamate 5 mg/kg s.c. twice daily for 2 d prior to study. All groups had similar values for mean pulmonary artery pressure (PAPm) and pulmonary vascular resistance (PVR) during room air and hypoxic ventilation. Isoproterenol in doses of 0.0025, 0.005, and 0.05 micrograms/kg per min produced a dose-related decline in PAPm and PVR during hypoxia in group 1. Despite beta-blockade with propranolol (group 2), isoproterenol at all three doses significantly reduced PAPm and PVR. The responses to isoproterenol were comparable in the presence or absence of propranolol; at 0.05 micrograms/kg per min the effects of isoproterenol were blunted, but not abolished, by propranolol. Similar results were observed even when five times the dose of propranolol was given. Isoproterenol at all three doses had no effect, however, on PAPm and PVR in the cyclooxygenase inhibitor-pretreated group. These data suggest that the pulmonary vasodilator effects of isoproterenol are not mediated solely by pulmonary vascular beta adrenergic receptors, and that vasodilator prostaglandins may play a role in the responses to this drug.
为了确定异丙肾上腺素产生的肺血管舒张是否仅由其β肾上腺素能效应介导,我们研究了三组因持续吸入10%氧气而导致肺血管收缩的犬对异丙肾上腺素的血流动力学反应:(a) 单纯缺氧组;(b) 缺氧并静脉推注0.3 mg/kg普萘洛尔,随后以5 μg/kg每分钟的速度输注的组;(c) 在研究前2天每天两次皮下注射5 mg/kg环氧化酶抑制剂(吲哚美辛或甲氯芬那酸)进行预处理后的缺氧组。在室内空气和低氧通气期间,所有组的平均肺动脉压(PAPm)和肺血管阻力(PVR)值相似。在第1组缺氧期间,每分钟0.0025、0.005和0.05 μg/kg剂量的异丙肾上腺素使PAPm和PVR呈剂量相关下降。尽管第2组用普萘洛尔进行了β受体阻滞,但所有三个剂量的异丙肾上腺素均显著降低了PAPm和PVR。无论有无普萘洛尔,对异丙肾上腺素的反应都是可比的;在每分钟0.05 μg/kg时,普萘洛尔使异丙肾上腺素的作用减弱,但未消除。即使给予五倍剂量的普萘洛尔,也观察到类似结果。然而,所有三个剂量的异丙肾上腺素对环氧化酶抑制剂预处理组的PAPm和PVR均无影响。这些数据表明,异丙肾上腺素的肺血管舒张作用并非仅由肺血管β肾上腺素能受体介导,血管舒张性前列腺素可能在对该药物的反应中起作用。