Bellissant E, Thuillez C, Richer C, Pussard E, Giudicelli J F
Service de Pharmacologie Clinique, Hôpital de Bicĕtre, Le Kremlin, France.
J Cardiovasc Pharmacol. 1994 Sep;24(3):500-8. doi: 10.1097/00005344-199409000-00020.
The effects of single oral doses of lisinopril (5 and 20 mg) on systemic and regional hemodynamics were investigated noninvasively in a placebo-controlled, randomized, double-blind, cross-over study of 6 healthy male volunteers. Lisinopril induced a dose-dependent (significant after 20 mg) and long-lasting (< or = 8 h) decrease in mean arterial pressure (MAP, approximately 11% after 20 mg) that was related to a decrease in total peripheral resistance (TPR), because simultaneously heart rate (HR) and cardiac output (CO) were unchanged. Brachial artery flow (+42 and +47% after 5 and 20 mg, respectively) and diameter (+8 and +9%) increased significantly, whereas brachial vascular resistance (-31 and -38%) decreased significantly from 2 to 8 h after drug intake. Common carotid artery flow (+20 and +24%) also increased significantly, whereas corresponding resistance (-18 and -26%) decreased significantly during the same period. Finally, CO was significantly redistributed toward the brachial and, to a lesser extent, the carotid vascular beds after both doses of lisinopril. We conclude that in healthy subjects lisinopril, at non- or slightly hypotensive doses, dilates both arterioles and large arteries and that this vasodilation is not homogeneous, affecting preferentially the brachial rather than the carotid vascular bed.
在一项针对6名健康男性志愿者的安慰剂对照、随机、双盲、交叉研究中,采用无创方法研究了单次口服赖诺普利(5毫克和20毫克)对全身和局部血流动力学的影响。赖诺普利可引起剂量依赖性(20毫克后显著)且持久(≤8小时)的平均动脉压降低(20毫克后约为11%),这与总外周阻力降低有关,因为同时心率(HR)和心输出量(CO)未发生变化。肱动脉血流(5毫克和20毫克后分别增加42%和47%)和直径(分别增加8%和9%)显著增加,而肱血管阻力在服药后2至8小时显著降低(分别降低31%和38%)。颈总动脉血流(分别增加20%和24%)也显著增加,而同期相应阻力(分别降低18%和26%)显著降低。最后,两种剂量的赖诺普利给药后,心输出量均显著重新分布至肱血管床,在较小程度上也重新分布至颈动脉血管床。我们得出结论,在健康受试者中,非降压或轻度降压剂量的赖诺普利可使小动脉和大动脉均扩张,且这种血管扩张并非均匀一致,优先影响肱血管床而非颈动脉血管床。