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口服降糖药格列齐特和甲苯磺丁脲对心血管系统的影响(作者译)

[Effects of oral hypoglycemic agents, gliclazide and tolbutamide, on the cardiovascular system (author's transl)].

作者信息

Maekawa H, Yamamoto J, Kato Y, Sekiya A

出版信息

Nihon Yakurigaku Zasshi. 1978 Jul;74(5):549-58. doi: 10.1254/fpj.74.549.

Abstract

Recent clinical studies have suggested an association of tolbutamide (TB) therapy with an increased incidence of cardiovascular deaths. In this study, the effects of a newly synthetized hypoglycemic agent, gliclazide (GC), on the cardiovascular system were investigated, and compared with those of TB. Results are as follows: GC was found to be about ten times as active as TB in decreasing blood glucose in rabbits. GC and TB produced a dose-dependent increase in blood pressure and little change in heart rate in rats and rabbits. In driven left rat and rabbit atria, these agents produced a positive inotropic effect. The positive inotropic effects of these drugs were not altered by pretreatment with propranolol, or theophylline. These agents produced little change in the rate in spontaneous beating rat, rabbit and guinea pig atria. Higher doses produced a slightly negative chronotropic response. Neither agent potentiated the intropic effects of isoproterenol on the rabbit and guinea pig left atria. In isolated perfused working rabbit hearts, these compounds produced a slight decrease in coronary flow. It is concluded that GC and TB possess positive inotropic effects on isolated atria, and these effects are not mediated either through adrenergic mechanisms or the cyclic AMP system.

摘要

近期的临床研究表明,甲苯磺丁脲(TB)治疗与心血管死亡发生率增加有关。在本研究中,研究了一种新合成的降糖药物格列齐特(GC)对心血管系统的影响,并与TB进行了比较。结果如下:发现GC在降低家兔血糖方面的活性约为TB的十倍。GC和TB使大鼠和家兔的血压呈剂量依赖性升高,心率变化不大。在离体大鼠和家兔心房中,这些药物产生正性肌力作用。普萘洛尔或茶碱预处理并未改变这些药物的正性肌力作用。这些药物对大鼠、家兔和豚鼠离体心房的自发搏动频率影响不大。高剂量时产生轻微的负性变时反应。两种药物均未增强异丙肾上腺素对家兔和豚鼠左心房的变力作用。在离体灌注的家兔工作心脏中,这些化合物使冠状动脉血流量略有减少。结论是,GC和TB对离体心房具有正性肌力作用,且这些作用既不通过肾上腺素能机制介导,也不通过环磷酸腺苷系统介导。

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