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吉林大学学报（医学版） 2006年第3期32卷 379-382页

作者：吕文伟曲极冰杨世杰吉林大学基础医学院药理学教研室吉林长春130021

目的:观察蒺藜皂苷(GSTT)对麻醉开胸犬血流动力学和氧代谢的影响。方法:实验犬30只随机分为5组(每组6只):生理盐水对照组、血塞通(阳性对照药物)组及GSTT低、中、高剂量(6.26、12.52和25.00 ***-1)组。采用静脉注射给药方式,检测血流动... 详细信息

目的:观察蒺藜皂苷(GSTT)对麻醉开胸犬血流动力学和氧代谢的影响。方法:实验犬30只随机分为5组(每组6只):生理盐水对照组、血塞通(阳性对照药物)组及GSTT低、中、高剂量(6.26、12.52和25.00 ***-1)组。采用静脉注射给药方式,检测血流动力学和氧代谢各项指标。结果:GSTT低、中及高剂量组犬心肌血流量高于对照组(P<0.01),平均动脉压、冠脉阻力、总外周血管阻力低于对照组(P<0.05或P<0.01),心肌耗氧量、心肌耗氧指数及心肌氧摄取率低于对照组(P<0.05或P<0.01)。结论:GSTT对麻醉开胸犬心脏功能有明显的调节和改善作用。

关键词：蒺藜/药理学皂苷类/药理学疾病模型动物血流动力学/药物作用氧耗量/药物作用

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麻黄素地塞米松预处理对骨水泥植入中血流动力学的保护作用

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中国误诊学杂志 2011年第4期11卷 828-828页

作者：于子红于泓波辽宁省沈阳市骨科医院麻醉科 110044

目的探讨股骨颈骨折行人工关节置换术植入骨水泥时用麻黄素地塞米松预处理患者的血压和心率的影响。方法股骨颈骨折行人工关节置换术患者460例,随机分为二组,Ⅰ组股骨颈骨折行人工关节置换术植入骨水泥前未预先用药;Ⅱ组股骨颈骨折在行... 详细信息

目的探讨股骨颈骨折行人工关节置换术植入骨水泥时用麻黄素地塞米松预处理患者的血压和心率的影响。方法股骨颈骨折行人工关节置换术患者460例,随机分为二组,Ⅰ组股骨颈骨折行人工关节置换术植入骨水泥前未预先用药;Ⅱ组股骨颈骨折在行人工关节置换术植入骨水泥前给地塞米松10 mg,麻黄素5 mg缓慢静脉注射。观察两组在植入骨水泥后HR,SBP,DBP,SaO2变化。结果Ⅰ组患者SBP,DBP,SaO2出现下降。Ⅱ组患者SBP,DBP,SaO2无明显变化。结论骨水泥充填前用给予地塞米松及麻黄素预处理,可以明显减少血压及血氧的波动,减少骨水泥综合征的发生率,对骨水泥综合征有预防作用。

关键词：麻黄碱/药理学地塞米松/药理学矫形外科手术骨代用品血流动力学/药物作用人类

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Hemodynamic and neuroendocrine effects for candoxatril and frusemide in mild stable chronic heart failure

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JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 1999年第6期34卷 1794-1801页

作者： Westheim, AS Bostrom, P Christensen, CC Parikka, H Rykke, EO Toivonen, L Ulleval Hosp Dept Cardiol N-0407 Oslo Norway Univ Helsinki Hosp Div Cardiol Helsinki Finland

OBJECTIVES The study aimed to assess the hemodynamic and neuroendocrine effects of candoxatril and frusemide compared with placebo in patients with mild chronic heart failure. BACKGROUND Candoxatril is an atriopeptidase inhibitor. It increases circulating levers of atrial natriuretic peptide leading to natriuresis and diuresis, which alleviate the symptoms of a failing heart. METHODS This was a multicenter, randomized, double-blind study. Forty-seven patients with mild stable chronic heart failure received candoxatril 400 mg/day, frusemide 40 mg/day or placebo for up to six weeks. Cardiac indices were determined at rest and during exercise, and blood samples were taken for laboratory analysis. Assessments were performed at baseline (day 0) and after six weeks (day 42). RESULTS In comparison with placebo, both drugs significantly reduced mean pulmonary capillary wedge pressure following the first dose administration. Only candoxatril significantly reduced pulmonary capillary wedge pressure during exercise on day 0, while both drugs significantly reduced this parameter on day 42. Changes in the remaining hemodynamic parameters were comparable for both drugs relative to placebo. Frusemide significantly increased mean plasma renin activity (days 0 and 42), and the mean aldosterone concentration (day 42) in comparison with placebo, whereas candoxatril caused no significant changes in any of the hormonal parameters assessed. CONCLUSIONS These results show that candoxatril, 400 mg/day, has a similar hemodynamic profile to frusemide, 40 mg/day, but it does not induce adverse neuroendocrine effects. Candoxatril. therefore appears to offer a clinically significant advantage over frusemide, providing an alternative therapeutic approach to the treatment of patients with mild stable chronic heart failure. (C) 1999 by the American College of Cardiology.

关键词：醛固酮/血液抗高血压药/药理学抗高血压药/治疗应用慢性病利尿药/药理学利尿药/治疗应用双盲法酶抑制剂/药理学酶抑制剂/治疗应用运动试验呋塞米/药理学心力衰竭/药物疗法心力衰竭/病理生理学血流动力学/药物作用茚满类/药理学茚满类/治疗应用脑啡肽酶/拮抗剂和抑制剂丙酸盐类/药理学丙酸盐类/治疗应用肺楔压/药物作用肾素/血液青少年成年人老年人人类中年人

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INHIBITION OF EFFERENT SYMPATHETIC-NERVE ACTIVITY BY 5-HYDROXYTRYPTOPHAN AND CENTRALLY ADMINISTERED 5-HYDROXYTRYPTAMINE

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NEUROPHARMACOLOGY 1975年第3期14卷 227-233页

作者： BAUM, T SHROPSHIRE, AT WYETH LABS INC CARDIOVASC PHARMACOL SECTRADNORPA 19087

In view of the similarity of the cardiovascular actions of the 5-hydroxytryptamine precursor 5-hydroxytryptophan (5-HTP) and those of l-DOPA and the finding that l-DOPA reduces efferent sympathetic nerve activity, the role of sympathetic outflow in the cardiovascular response to 5-HTP was examined in the present experiments. Intravenous injection of 5-HTP (3.2 32 mg/kg) after peripheral decarboxylase inhibition, resulted in a progressive reduction in blood pressure and heart rate in anaesthetized cats. Spontaneous electrical activity of the cardiac, renal and splanchnic nerves also decreased in a dose-related fashion. More direct administration of 5-HTP, as well as 5-hydroxytryptamine, to the brain via a lateral ventricle also produced a fall in pressure, heart rate and sympathetic nerve activity. These experiments indicate that the overall actions of 5-HTP on the central nervous system result in a diminution of sympathetic outflow leading to a reduction of blood pressure and heart rate and thus resemble the effects of l-DOPA. The actions of 5-hydroxytryptamine are consistent with the hypothesis that it mediates the response to 5-HTP.

关键词： 5-羟色氨酸/药理学血压/药物作用心电描记术心率/药物作用血流动力学/药物作用肾/神经支配神经元/药物作用血清素/药理学交感神经系统/药物作用动物猫男(雄)性

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JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 1999年第5期33卷 1174-1181页

作者： Havranek, EP Thomas, I Smith, WB Ponce, GA Bilsker, M Munger, MA Wolf, RA Univ Colorado Denver Hlth Med Ctr 0960 Hlth Sci Ctr Denver CO 80204 USA Slidell Mem Hosp Slidell LA USA Louisiana Cardiovasc Res Ctr New Orleans LA USA Adult Cardiovasc Dis Hernet CA USA Univ Miami Sch Med Miami FL USA Univ Utah Heart Failure Treatment Program Salt Lake City UT 84112 USA Bristol Myers Squibb Princeton NJ USA

OBJECTIVES The primary purpose of this study was to determine the acute and long-term hemodynamic and clinical effects of irbesartan in patients with heart failure. BACKGROUND Inhibition of angiotensin II production by angiotensin-converting enzyme (ACE) inhibitors reduces morbidity and mortality in patients with heart failure. Irbesartan is an orally active antagonist of the angiotensin II AT, receptor subtype with potential efficacy in heart failure. METHODS Two hundred eighteen patients with symptomatic heart failure (New York Heart Association [NYHA] class II-IV) and left ventricular ejection fraction less than or equal to 40% participated in the study. Serial hemodynamic measurements were made over 24 h following randomization to irbesartan 12.5 mg, 37.5 mg, 75 mg, 150 mg or placebo. After the first dose of study medication, patients receiving placebo were reallocated to one of the four irbesartan doses, treatment was continued for 12 weeks and hemodynamic measurements were repeated. RESULTS Irbesartan induced significant dose-related decreases in pulmonary capillary wedge pressure (average change -5.9 +/- 0.9 mm Hg and -5.3 +/- 0.9 mm Hg for irbesartan 75 mg and 150 mg, respectively) after 12 weeks of therapy without causing reflex tachycardia and without increasing plasma norepinephrine. The neurohormonal effects of irbesartan were highly variable and none of the changes was statistically significant. There was a significant dose-related decrease in the percentage of patients discontinuing study medication because of worsening heart failure. Irbesartan was well tolerated without evidence of dose-related cough or azotemia. CONCLUSIONS Irbesartan, at once-daily doses of 75 mg and 150 mg, induced sustained hemodynamic improvement and prevented worsening heart failure. (C) 1999 by the American College of Cardiology.

关键词：血管紧张素受体拮抗剂抗高血压药/投药和剂量抗高血压药/治疗应用联苯化合物/投药和剂量联苯化合物/治疗应用剂量效应关系药物双盲法用药计划表随访研究心力衰竭/血液心力衰竭/药物疗法心力衰竭/病理生理学血流动力学/药物作用去甲肾上腺素/血液受体血管紧张素 1型受体血管紧张素 2型安全单盲法四唑类/投药和剂量四唑类/治疗应用治疗结果青少年成年人女(雌)性人类男(雄)性中年人

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Effects of tocolytic treatment with ritodrine on cardiovascular autonomic regulation

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BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY 1999年第3期106卷 238-243页

作者： Vesalainen, RK Ekholm, EMK Jartti, TT Tahvanainen, KUO Kaila, TJ Erkkola, RU Univ Turku Cent Hosp Dept Med FIN-20520 Turku Finland Univ Turku Cent Hosp Dept Obstet & Gynaecol FIN-20520 Turku Finland Univ Turku Cent Hosp Dept Clin Pharmacol FIN-20520 Turku Finland Kuopio Univ Hosp Dept Clin Physiol SF-70210 Kuopio Finland

Objective To study the acute effects of tocolytic treatment with intravenous ritodrine on cardiovascular autonomic regulation. Design Validated methods to assess cardiovascular autonomic nervous function-heart rate and blood pressure variability and vagal cardiac baroreflex sensitivity-were measured before and during ritodrine infusion. Setting Turku University Central Hospital, Turku, Finland. Sample Twelve pregnant women admitted to hospital for threatened preterm labour. Methods Electrocardiogram and continuous noninvasive finger blood pressure signals were recorded in each woman, resting in a supine position. Autoregressive spectrum analysis was used to quantify short term heart rate and blood pressure variability. Vagal cardiac baroreflex sensitivity was measured as the bradycardia response to an intravenous bolus injection of phenylephrine. Main outcome measures Vagal cardiac baroreflex sensitivity and spectrum analysis indices of short term heart rate and blood pressure variability. Results Ritodrine significantly decreased vagal cardiac baroreflex sensitivity and as total (0.00-0.40 Hz), low frequency (0.04-0.15 Hz) and high frequency (0.15-0.04 Hz) power bands of the heart rate variability spectrum. Ritodrine significantly increased mean heart rate and the low frequency quency power band of the systolic blood pressure variability spectrum. Conclusions In pregnant women with threatened preterm labour intravenous administration of ritodrine decreases vagal cardiac baroreflex sensitivity and vagal modulation of heart rate, and increases sympathetically mediated blood pressure variability. Decreased baroreflex sensitivity and heart rate variability are known to be associated with a poor prognosis in some patient groups, so the effects of ritodrine tocolysis may be unfavourable in women with impaired circulatory homeostasis.

关键词：肾上腺素能β激动剂/药理学自主神经系统/药物作用自主神经系统/病理生理学压力感受器反射/药物作用血压/药物作用心率/药物作用血流动力学/药物作用分娩过早/药物疗法分娩过早/病理生理学利托君/药理学子宫收缩松解药/药理学青少年成年人女(雌)性人类妊娠

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EFFECTS OF MARIHUANA AND PLACEBO MARIHUANA SMOKING ON HEMODYNAMICS IN CORONARY-DISEASE

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CLINICAL PHARMACOLOGY & THERAPEUTICS 1975年第1期18卷 90-95页

作者： PRAKASH, R ARONOW, WS WARREN, M LAVERTY, W GOTTSCHALK, LA UNIV CALIF MED SERVIRVINECA UNIV CALIF PSYCHIAT SERVIRVINECA VET ADM HOSP MED SERVCARDIOL SECTLONG BEACHCA 90801

The effects of smoking 1 marihuana and 1 placebo marihuana cigarette on cardiovascular hemodynamics were evaluated by echocardiography in a double‐blind crossover study in 10 patients with angina pectoris. Smoking marihuana increased the heart rate and systolic and diastolic blood pressures, did not significantly change the end‐systolic volume and cardiac index, and decreased the end‐diastolic volume, stroke index, and ejection fraction. Smoking placebo marihuana did not significantly change the heart rate, blood pressure, and end‐systolic volume, and decreased the end‐diastolic volume, stroke index, cardiac index, and ejection fraction. The decrease in stroke index and ejection fraction after marihuana was greater and lasted longer than after placebo marihuana. The decrease in stroke index, cardiac index, and ejection fraction after placebo marihuana may be attributed to increased carboxyhemoglobin level. The increase in heart rate and blood pressure after marihuana is attributed to delta‐9‐tetrahydrocannabinol (THC). The decrease in stroke index and ejection fraction after marihuana may be attributed to delta‐9‐THC in addition to increased carboxyhemoglobin level.

关键词：心绞痛/病理生理学血压/药物作用大麻属/药理学心排血量/药物作用临床试验(主题) 冠心病/病理生理学超声心动描记术心率/药物作用血流动力学/药物作用安慰剂时间因素成年人人类男(雄)性中年人

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Randomized trial of candesartan cilexetil in the treatment of patients with congestive heart failure and a history of intolerance to angiotensin-converting enzyme inhibitors

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AMERICAN HEART JOURNAL 2000年第4期139卷 609-617页

作者： Granger, CB Ertl, G Kuch, J Maggioni, AP McMurray, J Rouleau, JL Stevenson, LW Swedberg, K Young, J Yusuf, S Califf, RM Bart, BA Held, P Michelson, EL Sellers, MA Ohlin, G Sparapani, R Pfeffer, MA Duke Clin Res Inst Durham NC USA Med Univ Klin Mannheim Heidelberg Germany Warsaw Univ Sch Med Warsaw Poland Mario Negri Inst Pharmacol Res I-20157 Milan Italy Univ Glasgow Glasgow G12 8QQ Lanark Scotland Montreal Heart Inst Montreal PQ H1T 1C8 Canada Brigham & Womens Hosp Boston MA 02115 USA Univ Gothenburg Gothenburg Sweden Cleveland Clin Fdn Cleveland OH 44195 USA McMaster Univ Hamilton ON Canada Astra Hassle AB Molndal Sweden Astra Merck Pharmaceut Inc Wayne PA USA

Background Many patients with congestive heart failure do not receive the benefits of angiotensin-converting enzyme (ACE) inhibitors because of intolerance. We sought to determine the tolerability of an angiotensin II receptor blocker, candesartan cilexetil, among patients considered intolerant of ACE inhibitors. Methods patients with CHF, left ventricular ejection Fraction less than 35%, and history of discontinuing an ACE inhibitor because of intolerance underwent double-blind randomization in a 2:1 ratio to receive candesartan (n = 179) or a placebo (n = 91). The initial dosage of candesartan was 4 mg/d;the dosage was increased to 16 mg/d if the drug was tolerated. A history of intolerance of ACE inhibitor was attributed to cough (67% of patients), hypotension (15%), or renal dysfunction (11%). Results The study drug was continued for 12 weeks by 82.7% of patients who received candesartan versus 86.8% of patients who received the placebo. This 4.1% greater discontinuation rate with active therapy was not significant;the 95% confidence interval ranged from 4.8% more discontinuation with placebo to 13% more with candesartan. Titration to the 16 mg target dose was possible for 69% of patients who received candesartan versus 84% of those who received the placebo. Frequencies of death and morbidity were not significantly different between the candesartan and placebo groups (death 3.4% and 3.3%, worsening heart failure 8.4% and 13.2%, myocardial infarction 2.8% and 5.5%, all-cause hospitalization 12.8% and 18.7%, and death or hospitalization for heart failure 11.7% and 14.3%). Conclusions Candesartan was well tolerated by this population. The effect of candesartan on major clinical end points, including death, remains to be determined.

关键词：血管紧张素转换酶抑制药/治疗应用抗高血压药/治疗应用苯咪唑类/治疗应用联苯化合物/治疗应用死亡原因剂量效应关系药物双盲法用药计划表心力衰竭/诊断心力衰竭/药物疗法心力衰竭/死亡率血流动力学/药物作用试点项目存活率四唑类心室功能障碍左/诊断心室功能障碍左/药物疗法心室功能左/药物作用老年人女(雌)性人类男(雄)性中年人

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β-blockade therapy in chronic heart failure:: Diastolic function and mitral regurgitation improvement by carvedilol

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AMERICAN HEART JOURNAL 2000年第4期139卷 596-608页

作者： Capomolla, S Febo, O Gnemmi, M Riccardi, G Opasich, C Caporotondi, A Mortara, A Pinna, G Cobelli, F Salvatore Maugeri Fdn Inst Med Care & Res Pavia Italy

Background In patients with chronic heart failure, the use of carvedilol therapy induces clinical and hemodynamic improvement. However, although the benefits of this beta-blocker have been established in patients with chronic heart failure, the mechanisms underlying them and the changes in left ventricular systolic function, diastolic function, and mitral regurgitation during long-term therapy remain unclear. Objective To identify the clinical and functional effects of carvedilol, focusing on diastolic function and mitrat regurgitation variations. Methods Forty-five consecutive patients with chronic heart failure (ejection fraction 24% +/- 7%), 17 with dilated ischemic and 28 with nonischemic cardiomyopathy, were treated with carvedilol (mean dose 44 +/- 30 mg) and matched for clinical (New York Heart Association functional class and heart Failure duration) and hemodynamic (cardiac index and pu lmonary wedge pressure) characteristics to a control group, Clinical and echocardiographic variables were measured in the 2 groups at baseline and after 6 months and the results compared. Results After 6 months of treatment with carvedilol, left ventricular election fraction had increased from 24% +/- 7% to 29% +/- 9% (P < .0001);this change was caused by a reduction in end-systolic volume index (106 +/- 41 vs 93 +/- 37 ml/m(2);P < .0001). Deceleration time of early diastolic filling increased (134 +/- 74 vs 196 +/- 63 ms;P < .0001). Seventeen of the 27 patients with demonstrated improvement of left ventricular diastolic filling moved From having a restrictive filling pattern to having a normal or pseudonormal left ventricular filling pattern. In the control group, no significant changes in deceleration time of early diastolic filling were found (139 +/- 74 vs 132 +/- 45 ms;P = not significant). The effective regurgitant orifice area decreased significantly in the carvedilol group but not in the control group. These changes were associated with a significant reduction of the

关键词：肾上腺素能β受体拮抗剂/治疗应用卡唑类/治疗应用心舒期/药物作用超声心动描记术/药物作用随访研究心力衰竭/诊断心力衰竭/药物疗法血流动力学/药物作用二尖瓣闭锁不全/诊断二尖瓣闭锁不全/药物疗法丙醇胺类/治疗应用心室功能障碍左/诊断心室功能障碍左/药物疗法心室功能左/药物作用成年人老年人女(雌)性人类男(雄)性中年人

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Responses to constant work rate bicycle ergometry exercise in primary pulmonary hypertension:: The effect of inhaled nitric oxide

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JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 2000年第2期36卷 547-556页

作者： Riley, MS Pórszász, J Engelen, MPKJ Shapiro, SM Brundage, BH Wasserman, K Univ Calif Los Angeles Harbor Med Ctr Div Resp & Crit Care Physiol & Med Torrance CA 90509 USA Univ Calif Los Angeles Harbor Med Ctr St Johns Cardiovasc Res Ctr Div Cardiol Torrance CA 90509 USA

OBJECTIVES The purpose of this study was to investigate the responses oipatients with primary pulmonary hypertension (PPH) to constant work rate exercise and to examine the effect of nitric oxide (NO) inhalation. BACKGROUND Maximal exercise tolerance is reduced in PPH, but gas exchange responses to constant work rate exercise have not been defined. We hypothesized that increased pulmonary vascular resistance in PPH would reduce the rate of rise of minute oxygen consumption in response to a given work rate. Because NO may lower pulmonary Vascular pressures in PPH, we also postulated that inhaled NO might ameliorate gas exchange abnormalities. METHODS Nine PPH patients and nine matched normal subjects performed 6-min duration constant work rate cycle ergometry exercise (33.9 +/- 13.4 W). Patients performed two experiments: breathing air and breathing air with NO (20 ppm). Preexercise right ventricular systolic pressure was assessed by Doppler echocardiography. Normal subjects performed the air experiment only. Gas exchange and heart rate responses were characterized by fitting monoexponential curves. RESULTS In PPH patients, resting right ventricular systolic pressure fell after NO inhalation (from 83.8 +/- 16.9 to 73.9 +/- 21.6 mm Hg, p < 0.01, analysis of variance with Tukey correction), but not after breathing air alone (from 88.0 +/- 20.8 to 86.7 +/- 20.6 mm Hg, p = NS). Nitric oxide did not affect any of the gas exchange responses. Minute oxygen consumption was similar by the end of exercise in patients and normals, but increased more slowly in patients (mean response time [MRT]: air, 63.17 +/- 14.99 s;NO, 61.60 +/- 15.45 s) than normals (MRT, 32.73 +/- 14.79, p < 0.01, analysis of variance, Tukey test). Minute oxygen consumption kinetics during recovery were slower in patients (MRT air: 82.50 +/- 29.94 s;NO, 73.36 +/- 15.87 s) than in normals (MRT, 34.59 +/- 7.11 s, p < 0.01). Heart rate kinetics during exercise and recovery were significantly slower in patients

关键词：心排血量/药物作用运动(Exercise)/生理学运动试验血流动力学/药物作用高血压肺性/药物疗法高血压肺性/病理生理学一氧化氮/药理学一氧化氮/治疗应用氧耗量肺换气/药物作用血管舒张药/药理学血管舒张药/治疗应用成年人女(雌)性人类中年人

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