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新型钙拮抗剂尼莫地平对正常血压和血压升高的血流动力学影响

[Hemodynamic effects of the new calcium antagonist nimodipine in normal and increased blood pressure].

作者信息

Engberding R, Bender F, Gülker H, Specker E, Molinski M

出版信息

Z Kardiol. 1984 Aug;73(8):498-503.

PMID:6495809
Abstract

The new compound nimodipine, a calcium channel-blocking agent, belongs to the dihydropyridine derivatives. In experimental studies it exhibits a preferential vasodilator action on cerebral vascular smooth muscle. We studied the hemodynamic effects of nimodipine in 8 normotensives (5 male, 3 female, mean age 47.8 +/- 3.7 years) and 8 patients (6 male, 2 female, mean age 57.4 +/- 2.6 years) with a systolic blood pressure greater than or equal to 165 mm Hg. After administration of nimodipine in hourly increasing doses of 0.015 mg/kg/h, 0.030 mg/kg/h and 0.045 mg/kg/h by an i.v. infusion, the following parameters were measured continuously: systolic, diastolic and mean arterial pressure (brachial artery), systolic and diastolic pulmonary artery pressure, pulmonary wedge pressure, cardiac and stroke volume index, total vascular resistance, stroke work index, blood flow in the legs by venous occlusion plethysmography and heart rate. Nimodipine provided a significant reduction of systolic, diastolic and mean arterial blood pressures when 0.015 and 0.030 mg/kg/h were infused. The higher dose of 0.045 mg/kg/h did not reduce these values any further. In normotensives cardiac index increased significantly. Hardly any changes in heart rate were observed. Total vascular resistance decreased significantly. Preload remained nearly unchanged. From these results it is concluded that the new calcium antagonist nimodipine provides potent vasodilator effects with a moderate reduction of blood pressure and without significant changes in heart rate.

摘要

新型化合物尼莫地平是一种钙通道阻滞剂,属于二氢吡啶衍生物。在实验研究中,它对脑血管平滑肌表现出选择性血管舒张作用。我们研究了尼莫地平对8名血压正常者(5名男性,3名女性,平均年龄47.8±3.7岁)和8名收缩压大于或等于165 mmHg的患者(6名男性,2名女性,平均年龄57.4±2.6岁)的血流动力学影响。通过静脉输注以每小时递增剂量0.015 mg/kg/h、0.030 mg/kg/h和0.045 mg/kg/h给予尼莫地平后,连续测量以下参数:收缩压、舒张压和平均动脉压(肱动脉)、收缩压和舒张压肺动脉压、肺楔压、心指数和每搏量指数、总血管阻力、每搏功指数、通过静脉阻塞体积描记法测量的腿部血流量和心率。当输注0.015和0.030 mg/kg/h时,尼莫地平可显著降低收缩压、舒张压和平均动脉血压。更高剂量0.045 mg/kg/h并未进一步降低这些值。在血压正常者中,心指数显著增加。几乎未观察到心率有任何变化。总血管阻力显著降低。前负荷几乎保持不变。从这些结果可以得出结论,新型钙拮抗剂尼莫地平具有强大的血管舒张作用,可适度降低血压,且心率无显著变化。

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