Zwillich C W, Martin B J, Rose C E
Clin Pharmacol Ther. 1980 Apr;27(4):454-9. doi: 10.1038/clpt.1980.63.
Organ selectivity of beta sympathetic blockade with propranolol was studied in 6 normal men by comparing the cardiovascular and respiration responses during isoproterenol infusions before and after propranolol. Beta sympathetic blockade was achieved with propranolol and was considered present when there was no heart rate (HR) response to isoproterenol during an infusion tenfold greater than that which raised HR 25% during a control period. During blockade there was no change in HR or systolic or diastolic blood pressure during isoproterenol infusions. There was a consistent (p less than 0.05) rise in resting ventilation (+17%), oxygen consumption (+9%), and carbon dioxide production (+15%) with low-dose (raised HR 10% before blockade) isoproterenol infusion during blockade. These respiratory effects of low-dose isoproterenol during cardiovascular blockade were quantitatively similar to that before blockade. With infusion that raised HR 25%, there was a further increase in VE, VO2, and VCO2 before blockade but no further increase during beta blockade. Changes in acid-base status did not explain the increase in VE during blockade. We conclude that there are differences between effectiveness of propranolol blockade of the cardiovascular system and of the respiratory system.
通过比较普萘洛尔给药前后异丙肾上腺素输注期间的心血管和呼吸反应,对6名正常男性进行了普萘洛尔β交感神经阻滞的器官选择性研究。普萘洛尔实现了β交感神经阻滞,当在输注期间对异丙肾上腺素的心率(HR)无反应时(输注剂量比在对照期使HR升高25%的剂量高10倍),则认为存在β交感神经阻滞。在阻滞期间,异丙肾上腺素输注期间HR、收缩压或舒张压均无变化。在阻滞期间,低剂量(在阻滞前使HR升高10%)异丙肾上腺素输注时,静息通气量(+17%)、耗氧量(+9%)和二氧化碳生成量(+15%)持续升高(p<0.05)。心血管阻滞期间低剂量异丙肾上腺素的这些呼吸效应在数量上与阻滞前相似。对于使HR升高25%的输注,阻滞前VE、VO2和VCO2进一步增加,但在β阻滞期间没有进一步增加。酸碱状态的变化无法解释阻滞期间VE的增加。我们得出结论,普萘洛尔对心血管系统和呼吸系统的阻滞效果存在差异。