硝苯吡啶对慢性肺心病呼衰脑循环影响及脑细胞保护作用

本文对22例肺心病呼吸衰竭患者进行了心、脑、肺血液动力学,血气及颈内静脉血乳酸(L)、丙酮酸(P)测定,其中11例仅给常规治疗为对照组,另11例在常规治疗基础上加用硝苯吡啶为实验组。结果显示,治疗前后两组脑血流量(CBF)基本不变;实验组治疗后CO明显增加,PpA,PVR,SVR,CBF/co,L/P明显下降,而对照组上述改变不大;治疗前两组VBO_2、O_2-extrB明显低于正常,治疗后仅实验组提高到大致正常水平。提示肺心病呼吸衰竭患者使用Nif不会诱发或加重肺性脑病,Nif对脑细胞功能具有保护作用。

EFFECTS OF NIFEDIPINE ON CEREBRAL CIRCULATION AND CEREBRAL CELLULAR FUNCTION IN ACUTE RESPIRATORY FAILRE OF PATIENTS WITH COR PULMONALE

The effects of nifedipine on cerebral circulation and cerebral cells were investigated in patients with cor pulmonale in the acute phase of respiratory failure. Twenty-two patients were assigned randomly to either trial group or control group. Both groups were treated with the same routine procedure. Nifedipine was given orally 10mg three times daily for two weeks in the trial group. This group showed a marked increased in cardiac output over the control group, but cerebral blood flow did not change in both groups. Systemic vascular resistance, pulmonary arterial mean pressure and pulmonary vascular resistance decreased noticeably in the trial group and so did lactatc-to-pyruvate ratio measured from intra-jugular blood. Lower oxygen consumption and oxygen extraction from cerebral blood approximated to iormal level in the trial group after treatment. it is concluded that nifedipine does not elicit and aggravate cerebral cdema and pulmonary encephalopathy in cor pulmonale: on the contrary, it has a protective cerebral cell function.