摘要
目的 探讨前列腺素E1(PGE1)在治疗风湿性心脏病合并肺动脉高压中的时效和量效关系。方法 选择 11例风湿性心脏病合并肺动脉高压患者 ,于麻醉后、手术前经右颈内静脉放置Swan Ganz漂浮导管到达肺动脉 ,检测应用PGE1前、后血流动力学指标的变化 ;应用PGE12 0ng·kg-1·min-1后分别于 0、5、10、2 0、30分钟检测血流动力学指标 ,以探讨其时效关系 ;分别应用PGE15、10、2 0、4 0、80ng·kg-1·min-1后检测血流动力学指标的变化 ,以探讨其量效关系。结果 ①应用PGE12 0ng·kg-1·min-15分钟后 ,血流动力学指标变化差异无统计学意义 (P >0 .0 5 ) ;10分钟后 ,平均肺动脉压 (mPAP)及平均肺毛细血管楔压 (mPCWP)明显降低 (P <0 .0 5 ) ;心脏指数 (CI)明显增加 (P <0 .0 5 )。 2 0、30分钟后上述指标变化不再明显 (P >0 .0 5 )。②应用PGE15、10ng·kg-1·min-1后 ,上述指标变化差异无统计学意义 (P >0 .0 5 ) ;应用PGE12 0、4 0、80ng·kg-1·min-1后 ,上述指标变化差异有统计学意义 (P <0 .0 5 )。结论 应用PGE1于 10分钟后开始起作用 ,2 0、30分钟后趋于平稳。PGE1的最佳有效剂量为 2 0～ 4 0ng·kg-1·min-1。
Objective To explore the time and dose-effect relationships of prostaglandin E 1(PGE 1) on pulmonary hypertension caused by rheumatic heart disease. Methods Eleven patients associated with pulmonary hypertension caused by rheumatic heart disease were selected. Swan-Ganz float catheter was inserted into pulmonary artery through right jugular just after anaesthesia. These indexes were examined both before and after using PGE 1 to study the effect on pulmonary hypertension;Those indexes were investigated after using PGE 1 at 0,5,10,20,30 minutes,respectively, to observe their time-effect relationship. Those indexes were also examined after using PGE 1 at the doses: 5,10,20,40,80 ng·kg -1·min -1 respectively, for their dose-effect relationship. Result ①After using PGE 1 20 ng·kg -1·min -1 5 minutes, there was no significant change (P> 0.05); after using PGE 1 20 ng·kg -1·min -1 10 minutes, mean pulmonary arterial pressure (mPAP) and mean pulmonary capillary wedge pressure (mPCWP) decreased significantly (P< 0.05); cardiac index(CI) increased significantly(P< 0.05); after using PGE 1 20 ng·kg -1·min -1 20 and 30 minutes, the effect was no more significant(P> 0.05). ②There was no significance after using PGE 1 at the dose of 5 or 10 ng·kg -1·min -1 (P> 0.05). The changes of mPAP,mPCWP and CI were significant after using PGE 1 at the dose of 20,40 or 80 ng·kg -1·min -1 (P< 0.05). Conclusion The effect is remarkable after using PGE 1 10 minutes and its effect is stable after 20 or 30 minutes. The optimal dose of PGE 1 is 20- 40 ng·kg -1·min -1.
出处
《临床荟萃》
CAS
北大核心
2004年第1期14-17,共4页
Clinical Focus
关键词
前列腺素E1
风湿性心脏病
肺动脉高压
时-效关系
量-效关系
prostaglandin E 1
rheumatic heart disease
pulmonary hypertension
time-effect relationship
dose-effect relationship
