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β1受体阻滞剂(心得宁)与慢性阻塞性肺疾病患者的运动

Beta1-blocker (practolol) and exercise in patients with chronic obstructive lung disease.

作者信息

Schaanning J, Vilsvik J S

出版信息

Acta Med Scand. 1976;199(1-2):61-4. doi: 10.1111/j.0954-6820.1976.tb06691.x.

Abstract

Ventilatory and circulatory data from 20 patients suffering from chronic obstructive lung disease have been obtained before, during and after exercise at 600 kpm/min for 5 min on a bicycle ergometer. The patients had been given intravenously practolol, 15 mg, or saline alternatively, using a double-blind cross-over technique. A slight postexercise reduction of FEV1 (8%) was noted after practolol medication as compared to placebo, with an accompanying decrease in PaCO2; PaO2 did not differ substantially. No wheezing or inappropriate dyspnea attributable to the medication was noted in any of the patients. The well known beta1-blocking effects on the circulation were confirmed, with maintained Q and reduced HR, together with a lowered systemic BP during and after exercise. There was a significant positive relationship between the postexercise reduction of FEV1 and the concomitant fall in HR. It is concluded that practolol in doses with near maximal circulatory effects had a slight, but clinically insignificant effect on the ventilatory parameters.

摘要

对20例慢性阻塞性肺疾病患者,在自行车测力计上以600千帕米/分钟的速度运动5分钟的过程中及运动前后,获取了通气和循环数据。采用双盲交叉技术,患者分别静脉注射15毫克心得宁或生理盐水。与安慰剂相比,心得宁用药后运动后第一秒用力呼气量(FEV1)略有下降(8%),同时动脉血二氧化碳分压(PaCO2)降低;动脉血氧分压(PaO2)无显著差异。所有患者均未出现因药物引起的喘息或不适当的呼吸困难。心得宁对循环系统的β1阻断作用得到证实,运动期间和运动后心输出量(Q)维持不变,心率(HR)降低,同时体循环血压下降。运动后FEV1的降低与同时出现的心率下降之间存在显著正相关。结论是,具有接近最大循环效应剂量的心得宁对通气参数有轻微但临床上无显著意义的影响。

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