Armstrong P W, Walker D C, Burton J R, Parker J O
Circulation. 1975 Dec;52(6):1118-22. doi: 10.1161/01.cir.52.6.1118.
Twenty-six patients with complicated acute myocardial infarction were studied in order to compare the hemodynamic effects of sodium nitroprusside (NP) and nitroglycerin (GTN). All patients received NP and 18 of the 26 also received GTN to evaluate both drugs in the same individuals. Both agents produced significant declines in mean arterial pressure, total peripheral resistance (TPR), and heart rate systolic blood pressure product. However, in the 18 patients who received both drugs GTN produced a greater fall (P less than 0.05) in pulmonary capillary wedge pressure (PCW) (25 to 15 mm Hg) than did NP (24 to 17 mm Hg) and a greater increment (P less than 0.01) in (see article) (0.98 to 1.43) than NP (0.98 to 1.16). These data confirm the potent vasodilatory effects of NP and GTN and suggest that NP has a relatively balanced effect on the arterial and venous circulation, and GTN seems to produce more potent venodilatation than arterial dilatation. These observations provide a basis for a more rational choice of vasodilator agents based on initial hemodynamic measurements in complicated acute myocardial infarction.
为比较硝普钠（NP）和硝酸甘油（GTN）对血流动力学的影响，对26例合并急性心肌梗死的患者进行了研究。所有患者均接受了NP治疗，26例患者中有18例还接受了GTN治疗，以便在同一患者身上评估这两种药物。两种药物均使平均动脉压、总外周阻力（TPR）和心率收缩压乘积显著下降。然而，在接受两种药物治疗的18例患者中，GTN使肺毛细血管楔压（PCW）（从25降至15mmHg）下降幅度大于NP（从24降至17mmHg）（P<0.05），（此处原文有误，应是某指标的增量）（从0.98增至1.43）大于NP（从0.98增至1.16）（P<0.01）。这些数据证实了NP和GTN强大的血管舒张作用，并表明NP对动脉和静脉循环有相对平衡的作用，而GTN似乎产生的静脉舒张作用比动脉舒张作用更强。这些观察结果为基于合并急性心肌梗死患者初始血流动力学测量更合理地选择血管扩张剂提供了依据。
