Gonschior P, Fleuchaus M, Larisch K, Stäblein A, Höfling B
Medizinische Klinik, Universität München.
Dtsch Med Wochenschr. 1995 Aug 25;120(34-35):1147-50. doi: 10.1055/s-2008-1055457.
To measure changes in haemodynamics and myocardial blood flow after acute intravenous (i.v.) and intracoronary (i.c.) injection of bisoprolol in patients with coronary heart disease.
A prospective, randomized controlled study of 14 patients (12 men, 2 women; mean age 65 [50-73] years) with angio-graphically proven coronary artery stenosis (reduced in lumen of at least 70%) in one or more major vessels. Seven patients received, before balloon angioplasty, either 0.01 mg/kg body weight directly into the coronaries (group 1, infusion through the guiding catheter) or 2.5 mg (group 2, via the sheath). Heart rate and blood pressure were measured before and after bisoprolol injection. Coronary blood flow was measured by the thermodilution method via two indwelling catheters in the coronary sinus.
After bisoprolol there was a reduction in heart rate (group 1: from 83/min to 75/min; group 2: from 77/min to 72/min) and blood pressure (group 1: from 137/80 mm Hg to 125/70 mm Hg; group 2: from 135/86 mm Hg to 126/80 mm Hg). Coronary blood flow was lower after i.c. bisoprolol injection than before (group 1: 383 ml/min vs 352 ml/min, but higher after i.v. injection (group 2: 353 ml/min vs 384 ml/min). These differences were statistically not significant.
While after-load was clearly reduced and myocardial blood flow remained unchanged, bisoprolol improved myocardial oxygen balance. No different effects could be detected after intracoronary vs intravenous application of bisoprolol.
测量冠心病患者急性静脉注射和冠状动脉内注射比索洛尔后血流动力学和心肌血流量的变化。
对14例患者（12例男性，2例女性；平均年龄65[50 - 73]岁）进行一项前瞻性随机对照研究，这些患者经血管造影证实一根或多根主要血管存在冠状动脉狭窄（管腔至少缩小70%）。7例患者在球囊血管成形术前，一组（1组）通过引导导管直接向冠状动脉内注入0.01mg/kg体重，另一组（2组）经鞘管注入2.5mg。在注射比索洛尔前后测量心率和血压。通过置于冠状窦的两根留置导管采用热稀释法测量冠状动脉血流量。
注射比索洛尔后，心率下降（1组：从83次/分钟降至75次/分钟；2组：从77次/分钟降至72次/分钟），血压下降（1组：从137/80mmHg降至125/70mmHg；2组：从135/86mmHg降至126/80mmHg）。冠状动脉内注射比索洛尔后冠状动脉血流量低于注射前（1组：383ml/分钟对352ml/分钟），但静脉注射后血流量升高（2组：353ml/分钟对384ml/分钟）。这些差异无统计学意义。
虽然后负荷明显降低且心肌血流量保持不变，但比索洛尔改善了心肌氧平衡。冠状动脉内注射与静脉注射比索洛尔未检测到不同效果。
