不同血管保存液对人桡动脉血管移植物的抗痉挛作用

目的 研究不同的血管保存液对人离体桡动脉痉挛的缓解与预防能力。方法 非体外循环冠状动脉旁路手术(OPCAB)19例患者,应用“无接触(No Touch)”外科技术获取自体桡动脉,保留未处理的远段0.8～1.5cm。应用血管环灌流技术(Organ Bath)比较不同保存液的抗痉挛作用和预防痉挛作用。结果 血管环灌流实验显示,在对痉挛状态桡动脉的舒张能力方面,PS、VG、DG、NG溶液均可以在10min内100％舒张血管,舒张曲线显示舒张能力依次为VG、DG、NG、PS,但差异无显著性(P>0.05),在预先浸泡处理桡动脉45～60min后,除对照组(Ringer's Solution)外,所有血管保存液均可以有效地预防离体桡动脉的痉挛,各组间差异无显著性(P>0.05)。结论 罂粟碱溶液、VG、DG、NG溶液均有较好的抗血管痉挛作用,单从抗血管痉挛角度考虑可以用作CABG手术中桡动脉的准备液。     

尼卡地平控制性降压对家犬脊髓血流的影响

目的　观察尼卡地平控制性降压对家犬脊髓血流的影响。方法　成年杂种犬 6只 ,体重 12 5～ 16kg ,以 2 5 %硫喷妥钠麻醉。股动脉置管监测MAP。以尼卡地平 8μg·kg 1·min 1持续静脉注射控制性降压。以激光多普勒血流仪测定脊髓血流 (SCBF)。结果　降压前MAP为 (12 5 7±10 6 )mmHg ,降压后为 (72 0± 11 2 )mmHg ,平均下降 4 2 8%。降压前SCBF为 (9 80± 1 0 5 )v ,降压后为 (8 0 4± 0 96 )v ,降低幅度为 18%。结论　尼卡地平控制性降压对SCBF影响较小 ,可安全用于脊髓手术。     

Nicardipine improves motor tics

Calcium channel blockers can act on dopaminergic systems, and some reports suggest that they could be useful for the treatment of several movement disorders. In order to assess the efficacy of nicardipine in tics disorders we performed a prospective open non-controlled study which included 10 previously untreated patients. Our results suggest that nicardipine could be a useful and safe treatment for tics.     

尼卡地平和硝酸甘油在体外循环中血压控制的比较

目的比较尼卡地平和硝酸甘油在体外循环中控制高血压的效果及对血流动力学的影响。方法40例冠状动脉旁路术(CABG)病人在体外循环(CPB)中平均动脉压升至10.7kPa时给予尼卡地平或硝酸甘油。将病人随机分为尼卡地平和硝酸甘油组,每组20例。观察两药起效时间,维持平均动脉压(MAP)在665～9.31kPa时所需剂量,开放升主动脉后心脏自动复跳情况以及停机后血流动力学的变化。结果将MAP从10.7kPa降至6.65～9.31kPa时,应用尼卡地平0.5mg,所需时间为(3.8±1.3)min,维持MAP在6.65～9.31kPa时所需剂量为(1.2±0.4)μg·kg     

尼卡地平预防双腔支气管导管插管反应的观察

目的　观察应用尼卡地平预防双腔支气管导管插管心血管反应的效果。　方法　肺、食道择期手术病人 40例 ,随机分为 2组 ,每组 2 0例。咪唑安定 0 .0 4mg/kg、异丙酚 1.5mg/kg、芬太尼 4μg/kg、维库溴铵 0 .12mg/kg静脉诱导后 ,甲组给予尼卡地平 4μg/kg ,乙组给予生理盐水 3ml作为对照。分别于诱导前、后 ,插管后即刻及 1、3、5min监测收缩压 (SBP)、舒张压 (DBP)、心率 (HR) ,并计算心率收缩压乘积 (RPP)。　结果　A组插管后血压无明显升高 ,心率较诱导前无明显增快 ,B组插管后血压明显升高。　结论　尼卡地平可抑制双腔支气管导管插管时的心血管副反应。     

Administration of antidepressants,diazepam and psychomotor stimulants further confirms the utility of Flinders Sensitive Line rats as an animal model of depression

Flinders Sensitive Line (FSL) rats have been proposed as an animal model of depression because they resemble depressed humans in that they have elevated REM sleep, reduced activity, and increased immobility and anhedonia after exposure to stressors. The present paper reviews experiments on the drug treatment of FSL and control Flinders Resistant Line (FRL) rats related to their utility as an animal model of depression, and presents new information. FSL rats exhibited exaggerated immobility in the forced swim test which is counteracted by the tricyclic antidepressants imipramine and desipramine and the serotonin reuptake blocker sertraline; the low immobility exhibited by the FRL rats is generally unaffected by these compounds. In contrast to these therapeutic effects of well recognized antidepressants, lithium and bright light treatment did not alter the exaggerated immobility of FSL rats. Novel data indicated that neither FSL nor FRL rats exhibited alterations in swim test immobility following chronic administration of the psychomotor stimulant amphetamine (2 mg/kg) and the anticholinergic scopolamine (2 mg/kg), which typically reduce immobility after acute administration. However, it was found that the calcium channel blockers verapamil (5 and 15 mg/kg) and nicardipine (10 mg/kg) did reduce the exaggerated immobility in FSL rats following chronic administration, suggesting that these compounds need to be evaluated further in humans. Previous studies have indicated no differences between FSL and FRL rats evaluated in the elevated plus maze, either at baseline or after the administration of diazepam, suggesting that the FSL rat may not differ from controls in anxiety-related behavior. Another recently published study showed that the FSL rat also did not differ from normal Sprague-Dawley rats in startle tests, indicating that the FSL rats do not exhibit behaviors shown in animal models of schizophrenia. These findings confirm the utility of FSL rats as an animal model of depression because the FSL rats do not appear to exhibit behaviors analogous to anxiety or schizophrenia and because they respond therapeutically to antidepressants and not psychomotor stimulants.     

Endothelin receptors and calcium translocation pathways in human airways

Tension and phosphatidyl inositol (PI) turnover experiments were conducted to investigate the receptors and signal transduction pathways responsible for contractions elicited by endothelin (ET) ligands in human bronchus. Nicardipine (1 μM), the L-type calcium channel inhibitor, or incubation in Ca²⁺-free medium, produced marked inhibition of contractions to the ET_B receptor-selective agonist, sarafotoxin S6c, and especially those induced by KCl. In contrast, Ca²⁺-free medium was without appreciable effect against contraction produced by endothelin-1 (ET-1), the non-selective ET_A and ET_B receptor agonist. In Ca²⁺-free medium, ryanodine (10 μM), which inhibits intracellular calcium mobilization, reduced sarafotoxin S6c- and ET-1-induced responses, but was without effect on responses to KCl. Similarly, nickel chloride (Ni²⁺; 1 mM) caused marked inhibition of contractions induced by sarafotoxin S6c or ET-1, but had no significant effect on KCl concentration-response curves. The mixed ET_A/ET_B receptor antagonist SB 209670 (3 μM) inhibited responses to sarafotoxin S6c and ET-1 such that concentration-response curves were shifted rightward, at the 30% maximum response level, by 10.0- and 3.8-fold, respectively, whereas BQ-123 (3 μM), the ET_A receptor antagonist, was without effect on responses induced by either agonist. ET-1 (1 nM–0.3 μM) caused a concentration-dependent stimulation of PI turnover, whereas sarafotoxin S6c (0.3 nM–0.1 μM) induced only small and variable increases, except at the highest concentration. The increase in PI turnover evoked by ET-1 was inhibited by SB 209670 (3 μM), and also by BQ-123 (3 μM). This is consistent with linkage of ET_A receptors to activation of inositol phosphate generation in human bronchial smooth muscle cells. Collectively, the data suggest that differences exist in the relative contributions of intracellular and extracellular Ca²⁺ mobilization mechanisms elicited by ET_A and ET_B receptor activation. Thus, sarafotoxin S6c-induced, ET_B receptor-mediated contraction in human bronchial smooth muscle appears to be dependent, in part, upon extracellular Ca²⁺, although a significant component of the response was also mediated by intracellular Ca²⁺ release, including from ryanodine-sensitive stores. ET_A receptor-mediated contraction of human airway smooth muscle was activated largely via the release of intracellular Ca²⁺. Received: 21 July 1998 / Accepted: 26 January 1999     

Use of nicardipine during pheochromocytoma removal

Key words  nicardipine - pheochromocytoma - hemodynamic and hormonal change     

尼卡地平控制性降压结合急性高容量血液稀释对腰椎手术患者输血量的影响

目的探讨尼卡地平控制性降压结合急性高容量血液稀释以减少腰椎手术患者输血量的可行性。方法择期椎板减压椎弓根内固定术患者64例，随机分为两组：对照组(Ⅰ组，n=32)和降压稀释组(Ⅱ组，n=32)。两组皆采用气管插管静吸复合麻醉，Ⅱ组麻醉诱导后，应用尼卡地平行控制性降压结合进行急性高容量血液稀释，比较两组患者所输异体血量和术后血红蛋白变化。结果Ⅱ组术中平均出血量比Ⅰ组减少50％，Ⅱ组术中平均输液量比Ⅰ组增加150％，而输血量为零。两组患者术后虽有轻度贫血，但仍在正常范围内。结论应用尼卡地平控制性降压结合急性高容量血液稀释可使行椎板减压椎弓根内固定术患者大量减少异体血的输入。     

尼卡地平与硝普钠用于主动脉腔内修复术控制性降压效果的比较

目的:观察尼卡地平用于覆膜支架主动脉腔内修复术中控制性降压的效果,并与传统降压药物硝普钠进行比较。方法:选用40例Standford B型主动脉夹层拟经股动脉行覆膜支架主动脉腔内修复手术患者,随机分为尼卡地平(N)组和硝普钠(S)组。观察2组降压前、降压4 min和停止降压后10 min、20 min的心率(HR)、收缩压(SBP)、舒张压(DBP)、中心静脉压(CVP)和收缩压与心率乘积(RPP)的变化。结果:应用两种方法均呈现较明显的降压效果。与降压前比较,SBP、DBP明显下降(P<0.01),N组HR无显著变化,S组HR明显增快(P<0.05)。停止用药后,N组血压变化平稳,缓慢回升;S组有血压反跳现象(P<0.05)。降压4 min时,N组RPP明显下降(P<0.05),S组RPP无显著变化。CVP无显著变化。结论:尼卡地平用于夹层动脉瘤覆膜支架主动脉腔内修复术中的控制性降压作用迅速,用药后对心率无显著影响,其效果优于硝普钠,特别适用于伴有冠心病行主动脉夹层腔内修复术的患者。