Lancelin B, Guermonprez J L, Bonin M, Maurice P
Nouv Presse Med. 1980 Sep 25;9(34 Suppl):2478-82.
In 12 patients aged from 45 to 75 years (mean : 62.57 +/- 8.37 years) a 2% percutaneous prepartion of nitroglycerin (PCNG) was applied on a square thoracic area measuring 15 x 15 cm, and its efficacy and duration of action were assessed by recording pressures in the right cavities and in the brachial artery. Left ventricular failure was due to recent myocardial infarction in nine cases, ischemic cardiopathy in two and non-obstructive cardiomyopathy in one. The 15 mg initial dose of PCNG was progressively increased until optimal dosage was reached. The efficacy of the drug was reflected in a significant fall in pulmonary artery diastolic pressure (PADP), equivalent to the mean capillary pressure, from 21.8 +/- 7.9 to 12.75 +/- 8.6 mmHg (p < 0.001). The mean systemic arterial pressure was reduced from 92.2 +/- 17.4 to 83 +/- 16.7 mmHg (P < 0.01). The cardiac index rose from 2.7 +/- 1 to 2.8 +/- 0.51/mn/m2 (N.S.) and the systolie index from 30.1 +/- 12.7 to 31.7 +/- 9.1 ml/systole/m2 (N.S.). Changes in PADP were significant (p < 0.05) during six hours and maximal at two hours (p < 0.001). There was a good correlation (r = 0.68 ; p < 0.02) between the time required to return to the initial values and the optimal fall in PADP. This shows that PCNG is undoubtedly long-acting in left ventricular failure, provided the doses are sufficient to induce a marked decrease in PADP.
在12例年龄为45至75岁（平均：62.57±8.37岁）的患者中，将2%的硝酸甘油经皮制剂（PCNG）涂抹于15×15平方厘米的方形胸部区域，通过记录右心腔和肱动脉的压力来评估其疗效和作用持续时间。9例左心室衰竭是由近期心肌梗死引起，2例由缺血性心脏病引起，1例由非梗阻性心肌病引起。PCNG的初始剂量为15毫克，逐渐增加直至达到最佳剂量。该药物的疗效表现为肺动脉舒张压（PADP）显著下降，相当于平均毛细血管压，从21.8±7.9降至12.75±8.6毫米汞柱（p<0.001）。平均体动脉压从92.2±17.4降至83±16.7毫米汞柱（P<0.01）。心脏指数从2.7±1升至2.8±0.5升/分钟/平方米（无统计学意义），收缩期指数从30.1±12.7升至31.7±9.1毫升/收缩期/平方米（无统计学意义）。PADP的变化在6小时内显著（p<0.05），在2小时时最大（p<0.001）。恢复到初始值所需时间与PADP的最佳下降之间存在良好的相关性（r=0.68；p<0.02）。这表明，只要剂量足以使PADP显著降低，PCNG在左心室衰竭中无疑具有长效作用。
