Abassade P, Baudouy P Y, Longueville G, Lung B, Dejode P, Guiomard A
Unité de Soins Intensifs Cardiologiques, Hôpital Saint Michel, Paris.
Ann Cardiol Angeiol (Paris). 1993 Jun;42(6):289-96.
Sublingual nifedipine has a rapid and powerful hypotensive effect. Its action on arterial distensibility can be assessed by measurement of pulse wave velocity (PWV) by Doppler echocardiography (DE). Ten patients were used to evaluate intra-observer reproducibility (Group 1). Fifteen hypertension patients (Group 2), not taking a calcium antagonist, 64 +/- 13 years-old, were studied by DE before and 15 minutes after 10 mg of SL nifedipine. The following were measured: systolic and diastolic blood pressures (SBP and DBP), heart rate (HR), echocardiographic shortening fraction (SF) and PWV, with sternal length (SL) taken as being identical to the length of the abdominal aorta between the isthmus and the coeliac region, and by measuring delta t: time interval for propagation of the pulsed Doppler velocimetric wave between the isthmic aorta and the coeliac aorta located by echocardiography: PWV = SL/delta t. Evidence was found in the nifedipine group (n = 15) of a fall in SBP (159.5 +/- 27.8 cf. 140.9 +/- 21 mmHg; p = 0.002); in DBP (88.6 +/- 13 cf. 79.6 +/- 8.3 mmHg; p = 0.005) and an increase in HR (72.3 +/- 10.7 cf. 76.8 +/- 12.9 bpm; p = 0.04). PWV decreased after nifedipine (10.5 +/- 3.9 cf. 7.15 +/- 12.9 bpm; p = 0.002). There was a linear correlation between the percentage reduction in PWV and left ventricular HR: y = 194x - 53; r = 0.56; p = 0.029.(ABSTRACT TRUNCATED AT 250 WORDS)
舌下含服硝苯地平具有快速且强效的降压作用。其对动脉扩张性的作用可通过多普勒超声心动图(DE)测量脉搏波速度(PWV)来评估。选取10名患者评估观察者内重复性(第1组)。对15名未服用钙拮抗剂、年龄为64±13岁的高血压患者(第2组),在服用10mg舌下含服硝苯地平前及15分钟后进行DE研究。测量以下指标:收缩压和舒张压(SBP和DBP)、心率(HR)、超声心动图缩短分数(SF)和PWV,胸骨长度(SL)视为与峡部和腹腔区域之间腹主动脉长度相同,并通过测量δt:脉冲多普勒测速波在峡部主动脉和经超声心动图定位的腹腔主动脉之间传播的时间间隔:PWV = SL/δt。在硝苯地平组(n = 15)中发现SBP下降(159.5±27.8对比140.9±21mmHg;p = 0.002);DBP下降(88.6±13对比79.6±8.3mmHg;p = 0.005)且HR增加(72.3±10.7对比76.8±12.9次/分钟;p = 0.04)。硝苯地平服用后PWV下降(10.5±3.9对比7.15±12.9次/分钟;p = 0.002)。PWV降低百分比与左心室HR之间存在线性相关性:y = 194x - 53;r = 0.56;p = 0.029。(摘要截选至250字)