Packer M, Meller J, Medina N, Gorlin R, Herman M V
Clin Pharmacol Ther. 1980 Mar;27(3):337-46. doi: 10.1038/clpt.1980.45.
Hemodynamic responses to different doses of hydralazine were evaluated in 18 patients with severe refractory resistant heart failure. There were no significant overall hemodynamic effects after 50 mg hydralazine. After 75 mg, CI increased slightly (+0.36 l/min/m2) with a 19% decrease in SVR. After 100 mg, there were substantial increases in CI (+0.60 l/min/m2) and decreases in SVR (31%) changes which were greater than those after 75 mg, but the decrease in MAP with 100 mg (-6.6 mm Hg) was of the same order as that after 75 mg (-5.0 mm Hg). LVFP and SWI improved significantly only with 100-mg doses. Seven patients in whom 100 mg hydralazine induced no hemodynamic effects all responded to single doses of 150 to 200 mg. The duration of action of hydralazine was longer (p less than 0.001) in patients with a CCr less than 35 ml/min (14.3 +/- 1.4 hr) than in patients with adequate renal function (7.9 +/- 0.5 hr). Thus, the dose and dosing interval of hydralazine needed to induce hemodynamic improvement in patients with severe heart failure are variable and require individualization.
在18例严重难治性耐药心力衰竭患者中评估了不同剂量肼屈嗪的血流动力学反应。50mg肼屈嗪后未观察到显著的总体血流动力学效应。75mg后，心脏指数（CI）略有增加（+0.36升/分钟/平方米），同时全身血管阻力（SVR）降低19%。100mg后，CI大幅增加（+0.60升/分钟/平方米），SVR降低（31%），变化大于75mg后，但100mg时平均动脉压（MAP）的降低（-6.6mmHg）与75mg后（-5.0mmHg）处于同一水平。仅100mg剂量时左室充盈压（LVFP）和每搏作功指数（SWI）显著改善。100mg肼屈嗪未产生血流动力学效应的7例患者对150至200mg单剂量均有反应。肌酐清除率（CCr）低于35ml/min的患者中，肼屈嗪的作用持续时间更长（p<0.001）（14.3±1.4小时），而肾功能正常的患者为（7.9±0.5小时）。因此，在严重心力衰竭患者中诱导血流动力学改善所需的肼屈嗪剂量和给药间隔是可变的，需要个体化。
