Keller C A, Shepard J W, Chun D S, Dolan G F, Vasquez P, Minh V D
Am Rev Respir Dis. 1984 Oct;130(4):606-11. doi: 10.1164/arrd.1984.130.4.606.
Reports on hemodynamic effects of hydralazine on pulmonary hypertension (primary or secondary) usually include cases with severe disease or with mixed varieties of pulmonary vascular disease. Serious side effects and death have been reported. Effects of this drug on ventilation and gas exchange are unknown. We investigated the short-term effects of hydralazine treatment on hemodynamics, ventilation, and gas exchange in a relatively homogeneous group of patients with severe chronic obstructive pulmonary disease and moderate exertional pulmonary hypertension (mean pulmonary artery pressure, 43 +/- 3 mmHg). Hydralazine produced significant improvement in cardiac index, total pulmonary resistance, and oxygen transport. We also observed significant improvement in alveolar ventilation (mean PaCO2, decreased from 47 +/- 2 to 40 +/- 3 mmHg at rest and from 51 +/- 3 to 43 +/- 3 mmHg during exercise). The severe exertional hypoxemia of the group (mean PaO2, 48 +/- 2 mmHg) improved significantly (mean PaO2, 57 +/- 3 mmHg). Four of 11 patients showed increased exercise tolerance after hydralazine. This change is probably related to a combined improvement in hemodynamics plus a newly observed improvement in gas exchange and ventilation. Three of 14 patients could not tolerate hydralazine because of marked tachycardia. Serious side effects were not observed in the remaining group.
关于肼屈嗪对肺动脉高压（原发性或继发性）血流动力学影响的报告通常包括患有严重疾病或患有混合类型肺血管疾病的病例。已有严重副作用和死亡的报告。该药物对通气和气体交换的影响尚不清楚。我们研究了肼屈嗪治疗对一组相对同质的重度慢性阻塞性肺疾病和中度运动性肺动脉高压（平均肺动脉压，43±3 mmHg）患者的血流动力学、通气和气体交换的短期影响。肼屈嗪使心脏指数、总肺阻力和氧输送有显著改善。我们还观察到肺泡通气有显著改善（静息时平均动脉血二氧化碳分压从47±2降至40±3 mmHg，运动时从51±3降至43±3 mmHg）。该组严重的运动性低氧血症（平均动脉血氧分压，48±2 mmHg）显著改善（平均动脉血氧分压，57±3 mmHg）。11名患者中有4名在使用肼屈嗪后运动耐量增加。这种变化可能与血流动力学的综合改善以及新观察到的气体交换和通气改善有关。14名患者中有3名因明显心动过速而不能耐受肼屈嗪。其余患者未观察到严重副作用。
