论文部分内容阅读
对慢性严重充血性心力衰竭患者采用口眼有效的增加心肌收缩力的药物,进行非卧床治疗法,这一措施是非常令人感兴趣的。为此,我们在九个严重心力衰竭患者身上比较了口服β-肾上腺素能受体兴奋剂吡丁舒喘宁和静脉注射多巴酚丁胺的血流动力学作用。这两种药物对心室的泵功能都产生了相同的效应,表现在:使心脏指数明显增加;心搏分数增加;心搏出功指数也增加。虽然多巴酚丁胺不会改变平均血压或左心室充盈压(P>0.005),但吡丁舒喘宁却使平均血压和左心室充盈压轻微地降低。此外,多巴酚丁胺减低全身血管阻力的22%,而吡丁舒喘宁却减低这一指数的42%。同时,这两种药都不改变心率或心率——收缩压的结果(P>0.005)。所以说,口服吡丁舒喘宁对左心室泵功能有与多巴酚丁胺同样有益的血流动力学作用,但是在总的全身血管阻力方面前者引起减低的幅度较大些。这些有治疗意义的血流动力学效应说明,口服吡丁舒喘宁长期治疗慢性严重充血性心力衰竭可能是有益的。新近采用了有效的口服血管扩张剂,使慢性严重充血性心力衰竭患者的疗效大有改进。因此,目前都主张把扩张体循环血管的药物与洋地黄和利尿剂一起作为常规的治疗措施,用以明显提高心室的泵功能,同时减低心室的前负荷。由于心肌的收缩力是心室泵功能的基本调节机制,而在严重充血性心力衰竭时使用洋地黄只能有限地增强这一心功能的主要环节。于是,在发展可靠而有效的口服增加心肌收缩力的药物方面,又提出了一个令人十分感兴趣的问题,这就是单独或合并使用有效的体循环血管扩张剂,裨能持久地提高衰竭心脏的功能。为此,我们评价了新的β-肾上腺素能受体兴奋剂吡丁舒喘宁对心功能的血流动力学影响,并把它与在慢性严重充血性心力衰竭患者身上静脉注射多巴酚丁胺所产生的血流动力学作用作了一番比较。
This approach is of great interest for patients with chronic severe congestive heart failure who use oral ophthalmically effective drugs that increase myocardial contractility for ambulatory treatment. To do this, we compared the effects of oral β-adrenergic receptor agonist picrotoxin and intravenous dobutamine on nine patients with severe heart failure. Both drugs have the same effect on the ventricular pump function as manifested by a significant increase in cardiac index, an increase in cardiac score, and an increase in cardiac workout index. Although dobutamine did not change mean blood pressure or left ventricular filling pressure (P> 0.005), it did slightly lower mean blood pressure and left ventricular filling pressure. In addition, dobutamine reduced systemic vascular resistance by 22%, whereas dipyridamole reduced 42% of this index. At the same time, neither of these two drugs changed heart rate or heart rate-systolic blood pressure (P> 0.005). Therefore, oral pipyridosalin has the same beneficial hemodynamic effects as dobutamine on left ventricular pump function, but the former causes a greater reduction in overall systemic vascular resistance. These therapeutic hemodynamic effects suggest that long-term treatment with oral dipyridamole may be beneficial in patients with chronic severe congestive heart failure. Recently adopted an effective oral vasodilators, the treatment of patients with chronic severe congestive heart failure has greatly improved. Therefore, it is currently advocated that the use of drugs that expand blood vessels and digitalis and diuretics as a routine treatment to significantly improve ventricular pump function, while reducing ventricular preload. Because myocardial contractility is a fundamental regulative mechanism of ventricular pump function, the use of digitalis in severe congestive heart failure can only marginally enhance the major aspects of this cardiac function. Thus, a very interesting issue has also been raised in the development of reliable and effective drugs for the oral administration of myocardial contractility, which is the use of effective systemic vasodilators, either alone or in combination, to prolong the failure of heart failure Features. To this end, we evaluated the hemodynamic effects of novel β-adrenoceptor agonist picatinol on cardiac function and compared it with intravenous injection of doxorubicin in patients with chronic severe congestive heart failure Butylamine produced hemodynamic effects made a comparison.