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巴氯芬对心肌需氧指标影响的脊髓起源证据。

Evidence for a spinal origin of the effect of baclofen on the myocardial oxygen demand indexes.

作者信息

Monassier L, Tibiriça E, Roegel J C, Feldman J, Bousquet P

机构信息

Laboratoire de Pharmacologie Cardiovasculaire et Rénale, CNRS URA 589, Faculté de Médecine, Université Louis Pasteur, Strasbourg, France.

出版信息

Naunyn Schmiedebergs Arch Pharmacol. 1995 Nov;352(5):550-6. doi: 10.1007/BF00169390.

Abstract

In a previous study in anaesthetized rabbits we observed that electrical stimulation of the hypothalamic paraventricular nucleus (PVN) elicited substantial rises in the maximum rate of change of left ventricular pressure (dP/dtmax) and in myocardial oxygen demand indexes (rate-pressure product and triple product), similar to the changes observed during stress or physical effort. Baclofen, a selective GABA(B) receptor agonist, injected intravenously prevented these responses. In the present study, we show that low doses of baclofen (0.1, 0.3 and 1 microgram/kg), injected intrathecally (i.t.) at the T9 level, reduced the myocardial oxygen demand during PVN stimulation. After 0.3 microgram/kg baclofen i.t., the peak value of the triple product during stimulation was 140 +/- 20 compared with 193 +/- 20 before treatment. An i.t. injection (500 micrograms/kg), of saclofen a selective GABA(B) receptor antagonist, did not modify the resting haemodynamics significantly but attenuated the inhibitory effects of baclofen (3 mg/kg i.v.). These results suggest that the main site of the effects of baclofen is located within the spinal cord and that GABA(B) receptors probably mediate these effects by modulating the central control of cardiac function. In conclusion, baclofen might be a useful tool to prevent the centrally evoked increases of myocardial oxygen demand.

摘要

在之前一项针对麻醉兔的研究中,我们观察到电刺激下丘脑室旁核(PVN)会使左心室压力最大变化率(dP/dtmax)以及心肌需氧指数(心率 - 血压乘积和三联乘积)大幅升高,这与在应激或体力活动期间观察到的变化相似。静脉注射巴氯芬(一种选择性GABA(B)受体激动剂)可阻止这些反应。在本研究中,我们发现,于T9水平鞘内注射低剂量的巴氯芬(0.1、0.3和1微克/千克)可降低PVN刺激期间的心肌需氧量。鞘内注射0.3微克/千克巴氯芬后,刺激期间三联乘积的峰值为140±20,而治疗前为193±20。鞘内注射选择性GABA(B)受体拮抗剂沙氯芬(500微克/千克)对静息血流动力学无显著影响,但减弱了巴氯芬(3毫克/千克静脉注射)的抑制作用。这些结果表明,巴氯芬作用的主要部位位于脊髓内,并且GABA(B)受体可能通过调节心脏功能的中枢控制来介导这些作用。总之,巴氯芬可能是预防中枢诱发的心肌需氧量增加的有用工具。

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