腺苷对犬急性低氧性肺动脉高压的血流动力学效应

为探讨腺苷在低氧性肺动脉高压中扩血管作用的量效关系，采用静脉匀速滴注腺苷的方法观察８只低氧性肺动脉高压犬的血流动力学变化。结果：腺苷能明显降低模型犬的体、肺循环压力及体、肺循环阻力，且与剂量呈直线负相关（ｒ＝－０．９７０～－０．９９４，Ｐ＜０．０５）。腺苷剂量在１００～２００μｇ／（ｋｇ·ｍｉｎ）时，肺循环收缩压及阻力的降低百分比（－１１．０％±４．２％～－２７．７±１４．８％、－１８．８％±８．０５％～－２９．８％±１４．４６％）明显高于体循环收缩压及阻力（－２．６％±７．４％～－１４．９％±７．０％、－１０．２％±６．８６％～－２１．１％±９．５３％）。腺苷剂量≥３００μｇ／（ｋｇ·ｍｉｎ）时心输出量、心搏指数有显著性增加。结论：腺苷具有最佳选择性肺循环扩血管作用的剂量范围在１００～２００μｇ／（ｋｇ·ｍｉｎ），是目前较理想的替代妥拉苏林的一种药物。

Dose-related Response of Adenosine in Hypoxic Pulmonary Hypertension in Canines

The vasodilator test is of critical importance in determining the reversibility of pulmonary hypertension and hence the indication of surgical treatments for cases of marginal pulmonary hypertension associated with left to right shunt. This study aimed at the doserelated vasodilation effect of adenosine (AD) on hypoxic pulmonary hypertension. The hemodynamic indexes were examined in 8 canines with acute hypoxic pulmonary hypertension after administration of intravenous adenosine. The results showed that AD decreased both systemic and pulmonary pressures in a dosedependent way, with very close linear correlation; so did the systemic and pulmonary resistance (r=-0.970 and -0.994, respectively; P<0.001). The PASP reductions were significantly greater than SASP reductions at AD doses of 100 to 200g/(kgmin) ( from -11.0%4.2% to -27.7.8% vs from -2.6%7.4% to -14.9%7.0%, respectively), while PVR reductions were significantly greater than SVR reductions (-18.8%8.05% vs -10.2%6.86% and -29.8.46% vs -21.1%9.53%, respectively, P<0.05). AD increased cardiac output and cardiac index to the significant degree only when the dosage increased to 300g/(kgmin) or above. These results suggest that AD seems to be the choice of drug in vasodilator test of left to right shunt pulmonary hypertension, and the proper dosage ranges from 100 to 200g/(kgmin).