Ma S, Long J P
Department of Pharmacology, College of Medicine, University of Iowa, Iowa City 52242.
J Cardiovasc Pharmacol. 1993 Jan;21(1):136-43. doi: 10.1097/00005344-199301000-00020.
Nitroglycerin (NTG) may cause paradoxical bradycardia and occasional life-threatening hypotension. The mechanism is unclear. In this study, we compared the cardiovascular responses of sodium nitroprusside (SNP) with that of NTG in rats with sinoaortic deafferentation (SAD). Intravenous (i.v.) injection of SNP and NTG produced dose-dependent decreases in mean arterial pressure (MAP). SNP was more effective than NTG in increasing heart rate (HR). After SAD, tachycardiac responses to i.v. SNP were abolished, but i.v. NTG caused bradycardia. SAD enhanced the hypotensive responses of both NTG or SNP after i.v. administration. The bradycardic and hypotensive effects of NTG were attenuated by either bilateral vagotomy or intracisternal (i.c.) pretreatment with 20 nmol rauwolscine, but the responses were not altered by i.v. atropine methylbromide (M-atropine), 0.6 mumol. In contrast, cardiovascular responses to i.v. SNP after SAD were not altered by these pretreatments. Tachycardiac responses to intracerebroventricular (i.c.v.) injection of NTG were reduced by SAD, but SAD did not alter bradycardic responses to i.c. injection of NTG. These results suggest that NTG induces inhibitory reflexes that may contribute to its complex cardiovascular responses in rats. The drug may stimulate peripheral sensory receptors with vagal afferents to the medulla, which then triggers an alpha 2-adrenoceptor-mediated sympathoinhibition.
硝酸甘油(NTG)可能会引起反常性心动过缓和偶尔的危及生命的低血压。其机制尚不清楚。在本研究中,我们比较了硝普钠(SNP)与NTG对去窦弓神经大鼠(SAD)的心血管反应。静脉注射(i.v.)SNP和NTG可使平均动脉压(MAP)呈剂量依赖性降低。SNP在增加心率(HR)方面比NTG更有效。SAD后,对静脉注射SNP的心动过速反应消失,但静脉注射NTG会导致心动过缓。SAD增强了静脉注射后NTG或SNP的降压反应。NTG的心动过缓和降压作用可通过双侧迷走神经切断术或脑池内(i.c.)预先给予20 nmol萝芙木碱而减弱,但静脉注射0.6 μmol甲基溴阿托品(M-阿托品)对此反应无改变。相比之下,这些预处理并未改变SAD后对静脉注射SNP的心血管反应。SAD可降低对脑室内(i.c.v.)注射NTG的心动过速反应,但SAD并未改变对脑池内注射NTG的心动过缓反应。这些结果表明,NTG诱导的抑制性反射可能是其在大鼠中复杂心血管反应的原因。该药物可能刺激外周感觉受体,通过迷走神经传入至延髓,进而触发α2-肾上腺素能受体介导的交感神经抑制。