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下肢闭塞性动脉硬化症患者的全身动脉顺应性。关于静脉注射普萘洛尔效果的观察。

Systemic arterial compliance in patients with arteriosclerosis obliterans of the lower limbs. Observations on the effect of intravenous propranolol.

作者信息

Levenson J A, Simon A C, Fiessinger J N, Safar M E, London G M, Housset E M

出版信息

Arteriosclerosis. 1982 May-Jun;2(3):266-71. doi: 10.1161/01.atv.2.3.266.

Abstract

Hemodynamic parameters and systemic arterial compliance were measured in patients with arteriosclerosis obliterans of the lower limbs before and after acute administration of propranolol. Arterial compliance was evaluated from a simple viscoelastic model, enabling the calculation of diastolic drainage and diastolic blood flow as indices of the reservoir role of the larger arteries in overall circulation. In comparing basal conditions with normal subjects of the same age, patients with arteriosclerosis obliterans exhibited a significant decrease in arterial compliance (p less than 0.01) and heart rate (p less than 0.02) with a significant increase in systolic pressure (p less than 0.001). Diastolic drainage was increased (p less than 0.01) and was positively correlated with diastolic time (r = 0.73, p less than 0.001). Diastolic blood flow remained within normal ranges (52 +/- 2 vs 49 +/- 3 ml/m2/sec). After acute propranolol intravenous administration, heart rate and stroke volume decreased (p less than 0.001), while total peripheral resistance increased (p less than 0.001). Systemic arterial compliance and diastolic blood flow significantly decreased (p less than 0.01). The study provided evidence that in patients with arteriosclerosis obliterans, the diastolic blood flow was maintained in basal conditions despite the observed reduction in arterial compliance, and that intravenous propranolol administration decreased systemic arterial compliance and diastolic blood flow.

摘要

在下肢闭塞性动脉硬化患者急性给予普萘洛尔前后,测量其血流动力学参数和全身动脉顺应性。动脉顺应性通过一个简单的粘弹性模型进行评估,该模型能够计算舒张期排空和舒张期血流量,以此作为大动脉在整体循环中储存功能的指标。与同年龄的正常受试者的基础状态相比,闭塞性动脉硬化患者的动脉顺应性显著降低(p<0.01),心率降低(p<0.02),收缩压显著升高(p<0.001)。舒张期排空增加(p<0.01),且与舒张期时间呈正相关(r = 0.73,p<0.001)。舒张期血流量保持在正常范围内(52±2 vs 49±3 ml/m2/秒)。急性静脉注射普萘洛尔后,心率和每搏输出量降低(p<0.001),而总外周阻力增加(p<0.001)。全身动脉顺应性和舒张期血流量显著降低(p<0.01)。该研究提供的证据表明,在闭塞性动脉硬化患者中,尽管观察到动脉顺应性降低,但基础状态下舒张期血流量仍保持稳定,且静脉注射普萘洛尔会降低全身动脉顺应性和舒张期血流量。

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