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硝酸甘油作用后肺小静脉和动脉血管直径的变化(作者译)

[Changes in diameters of small pulmonary venous and arterial vessels after nitroglycerin (author's transl)].

作者信息

Kober G, Grossmann R, Schulz W, Kaltenbach M

出版信息

Z Kardiol. 1981 Jul;70(7):547-54.

PMID:6791396
Abstract

Diameters of the small arterial and venous pulmonary vessels were studied in 17 patients, using selective pulmonary angiography. The majority had coronary heart disease. Pulmonary and systemic hemodynamics were also evaluated. In 11 patients, these procedures were repeated 3 minutes after the sublingual administration of 1.6 mg of nitroglycerin (Group I). The remaining 6 patients served as controls (Group II). In Group I, pulmonary circulatory pressures, left ventricular filling pressure, and pulmonary vascular resistance declined significantly compared with Group II. The diameters of the small pulmonary veins declined by more than 10 percent in Group I while remaining constant in Group II. Differences between the two groups in terms of the response of the small arterial vessels was less evident. Increases in vessel cross-sectional area were observed despite considerably reduced intravascular pressure. The increase in elasticity and capacitance of the pulmonary vessels following nitroglycerin is more pronounced on the venous than on the arterial side. These findings suggest that the pulmonary vascular bed contributes significantly to the therapeutically important pooling effect caused by nitroglycerin in the treatment of angina pectoris and pulmonary edema.

摘要

采用选择性肺血管造影术,对17例患者的肺小动脉和静脉直径进行了研究。大多数患者患有冠心病。同时还评估了肺循环和体循环血流动力学。11例患者在舌下含服1.6毫克硝酸甘油3分钟后重复上述检查(第一组)。其余6例患者作为对照(第二组)。与第二组相比,第一组的肺循环压力、左心室充盈压和肺血管阻力显著下降。第一组肺小静脉直径下降超过10%,而第二组保持不变。两组在小动脉血管反应方面的差异不太明显。尽管血管内压力显著降低,但仍观察到血管横截面积增加。硝酸甘油使肺血管弹性和容量增加,在静脉侧比在动脉侧更明显。这些发现表明,在治疗心绞痛和肺水肿时,肺血管床对硝酸甘油引起的具有重要治疗意义的血液蓄积作用有显著贡献。

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