Timmis A D, Rothman M T, Henderson M A, Geal P W, Chamberlain D A
Br Med J. 1980 Apr 5;280(6219):980-2. doi: 10.1136/bmj.280.6219.980.
The haemodynamic effects of intravenous morphine sulphate (0.2 mg/kg body weight) were measured in 10 patients with acute myocardial infarction complicated by severe left ventricular failure. Fifteen minutes after morphine injection there was a significant fall in mean heart rate (from 109 to 101 beats/min) and mean systemic arterial pressure (from 80 to 65 mm HG), and a small fall in mean cardiac index (from 2.4 to 2.21/min/m2). Haemodynamic changes at 45 minutes were similar. Neither stroke index nor indirect left ventricular filling pressure (measured as pulmonary artery end-diastolic pressure) were consistently improved 15 or 45 minutes after injection. The useful action of morphine in relieving distressing cardiac dyspnoea is not adequately explained by systemic venous blood pooling. These results suggest that the effects of morphine on the central nervous system are more important.
对10例急性心肌梗死合并严重左心室衰竭的患者，测定了静脉注射硫酸吗啡（0.2mg/kg体重）后的血流动力学效应。注射吗啡15分钟后，平均心率显著下降（从109次/分钟降至101次/分钟），平均体循环动脉压显著下降（从80mmHg降至65mmHg），平均心脏指数略有下降（从2.4降至2.2L/分钟/平方米）。45分钟时的血流动力学变化相似。注射后15分钟或45分钟，每搏指数和间接左心室充盈压（以肺动脉舒张末期压力测量）均未持续改善。吗啡缓解令人痛苦的心脏性呼吸困难的有效作用不能通过体循环静脉血淤积得到充分解释。这些结果表明，吗啡对中枢神经系统的作用更为重要。
