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使用β-拟交感神经药物(酚丙喘宁和己酮可可碱)治疗期间的心脏功能指标。

Indices of cardiac function during treatment with betamimetic drugs (fenoterol and hexoprenaline).

作者信息

Siekmann U, Heilmann L, Irmer M

出版信息

Arch Gynecol. 1983;233(2):73-83. doi: 10.1007/BF02114783.

Abstract

The limiting factor in the treatment of preterm labor by betamimetics is the effect of these drugs on heart rate and cardiac action. In this paper we compare these effects produced by hexoprenaline and fenoterol, which are both beta-sympathomimetic drugs now in clinical use. As indices of cardiac action we measured the pre-ejection period (PEP), the left ventricular ejection time (LVET) and their sum, namely total electromechanical systole (QS2) by thoracic impedance cardiography. In 20 individual tests, seven subjects were given both hexoprenaline and fenoterol on separate occasions in a dose relationship of 1 : 12.5. We found a relation between PEP/LVET on the one hand and the Heather-index (an impedance specific parameter of response to stress) on the other. Both parameters represent inotropic effects in cardiac action. With increasing betamimetic stimulation there was a decrease of PEP/LVET (-23% for hexoprenaline and -29% for fenoterol) and an increase in the Heather-index (+98% for hexoprenaline and +117% for fenoterol). These results are not statistically significantly different and so we cannot agree with Lipshitz [19 ]who reported less beta 1-stimulation with hexoprenaline.

摘要

β-拟交感神经药治疗早产的限制因素是这些药物对心率和心脏活动的影响。在本文中,我们比较了已用于临床的两种β-拟交感神经药六甲双铵和酚丙喘宁产生的这些影响。作为心脏活动指标,我们通过胸阻抗心动图测量了射血前期(PEP)、左心室射血时间(LVET)及其总和,即总电机械收缩期(QS2)。在20项个体测试中,7名受试者在不同时间分别接受了六甲双铵和酚丙喘宁,剂量比为1:12.5。我们发现一方面PEP/LVET与希瑟指数(一种对应激反应的阻抗特异性参数)之间存在关联。这两个参数均代表心脏活动中的变力作用。随着拟交感神经刺激增强,PEP/LVET降低(六甲双铵降低23%,酚丙喘宁降低29%),希瑟指数升高(六甲双铵升高98%,酚丙喘宁升高117%)。这些结果在统计学上无显著差异,因此我们不同意利普希茨[19]的观点,他报告六甲双铵的β1刺激作用较小。

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