硝苯地平与卡托普利单用及联合应用对低氧性肺动脉高压的作用

目的 :探讨硝苯地平与卡托普利单用及联用对低氧性肺动脉高压 (PAH)的作用。方法 :30例慢性阻塞性肺疾病 (COPD)合并肺心病病人 ,通过Swan_Ganz导管分别观察了硝苯地平 2 0mg舌下含服与卡托普利 2 0mg静脉注射 ,单用或 2药联用 3组各 10例对平均肺动脉压 (MPAP)等血流动力学参数的影响。结果 :硝苯地平无明显降低MPAP、肺血管阻力 (PVR)的作用 (P >0 .0 5) ,但却显著降低体循环平均压 (MAP )、动脉血氧分压Pao2 (P <0 .0 1,P <0 .0 5)。卡托普利可显著降低MPAP和PVR(P <0 .0 5) ,对MAP和Pao2 无明显的影响。 2药联用可更显著地降低MPAP、PVR (P <0 .0 1)。结论 :卡托普利是治疗低氧性PAH的一个有效药物 ,与硝苯地平联用有协同作用

Effects of nifedipine and captopril, alone or combined, on hypoxic pulmonary hypertension

AIM: To compare the effects of nifedipine and captopril, alone or combined, on hypoxic pulmonary hypertension. METHODS: We chose 30 patients with chronic obstructive pulmonary diseases (COPD) and complication cor pulmonale assigned them into 3 groups (10 patients each). We observed the effects before and after administration of nifedipine 20 mg sublingually, captopril 20 mg intravenously, and combined on the hemodynamics through Swan_Ganz catheter. RESULTS: After using 20 mg nifedipine, the mean pulmonary artery pressure (MPAP) and pulmonary vascular resistance (PVR) did not change much (P>0.05), but the mean systemic artery pressure (MAP) and arterial blood oxygen partial pressure (Pao 2) decreased obviously (P<0.01, P<0.05); after administered 20 mg captopril, the MPAP and PVR decreased (P<0.05), while MAP and Pao 2 did not change much; when combined nifedipine 20 mg with captopril 20 mg, MPAP and PVR decreased more (P<0.01). CONCLUSIONS: Captopril is an effective drug for the treatment of hypoxic pulmonary hypertension; combining nifedipine with captopril has a synergistic action.