硝苯吡啶对充血性心力衰竭病人静息及运动时的血流动力学效应

作者观察了27例充血性心力衰竭(CHF)病人用硝苯吡啶(NFP)治疗后的静息及运动血流动力学效应,和 NFP 对 CHF 血浆去甲肾上腺素(NE)、血乳酸、肺动脉二氧化碳分压(PCO_2)及肺动脉血氧饱和度(O_2Sat)的影响,结果表明:NFP使静息及运动状态下的平均动脉压(MBP)、肺动脉舒张末期压(PAEDP)、体循环血管阻力(SVR)明显下降(P<0.01),每搏输出量(SV)及每搏指数(SVI)明显增加(P<0.05),使左室作功曲线向左上移动。NFP 使血浆 NE 明显下降(P<0.05),NFP 对血乳酸、O_2Sat、PCo_2无影响(P>0.05)。提示:NFP 改善大多数 CHF 病人静息及运动状态下的血流动力学,无反射性交感神经紧张。可安全地用于大多数 CHF 病人。

HEMODYNAMIC EFFECT OF NIFEDIPINE IN PATIENTS WITH CONGESTIVE HEART FAILURE DURING REST AND EXERCISE

In order to investigate the clinical value of nifedine(NFP)in congestive heart failure(CHF),27 patients with CHF were studied on the effects of rest and exercise hemodynamics,plasma norepinedrine,blood lactate,pulmonary artery carbon dioxide tension(PCO_2)and pulmonary artery oxygen saturation(O_2Sat)after oral NFP 20mg. The results showed that mean blood pressure(MBP),pulmonary end-diastolic pressure PAEDP)and systemic vascular resistance(SVR)decreased(P<0.01),stroke volume(SV) and stroke volume index(SVI)increased(P<0.05)during rest and exercise.The fun- ctional curve of left ventricle shifted to the left-upwards.Plasma norepinephrine de- creased(P<0.05)but blood,lactate,O_2Sat and PCO_2 unchanged(P<0.05).It is sugg- ested that NFP improves rest and exercise hemodynamics in most of the CHF patien- ts,does not have reflex sympathetic activation Therefore,NFP can be safely used in most of the CHF patients.