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已有许多实验提示前列腺素在冠状血管调节中有重要作用。作者选择9例2周内未用过消炎痛或其他非激素抗炎药物的严重冠心病患者,静脉注射消炎痛以探讨本药对冠状血管的收缩作用。患者平卧后,将动脉导管安置于患者的臂动脉或股动脉中,与微型传感器相连以持续测量动脉血压。经臂静脉把热稀释导管插进冠状窦内,用持续热稀释法测定忠者的冠状窦血流。静脉注射消炎痛0.5 mg/Kg前,和20min 后测定患者的动脉血压、冠状窦血流和动脉一冠状窦含氧量差。结果注射消炎痛后,患者的平均动脉压自99±4升至118±5mmHg(P<0.005);心脏需氧量自10.6±0.7增至12.3±0.9次·mmHg×10~3/min(P<0.05);冠状血流减少39%(P<0.05);平均动脉-冠状窦血含氧量差增加29%(P<0.001),平均冠状血管阻力增加73%(P<0.05)。讨论冠状循环的调节机制尚未完全明瞭,已对神经、激素、血液动力学及代谢性影响等进行了研究。自 Vane(1971)报道消炎痛通过阻断环化氧合酶而抑制前列腺素合成以来,已有很多证据说明前列腺素对冠状血管的调节作用。目前仍未有关于短期静脉注射消炎痛抑制前列腺素合成的资料,本研究亦未测定
Many experiments have suggested that prostaglandins play an important role in the regulation of coronary vessels. The authors chose 9 patients with severe coronary heart disease who had not used indomethacin or other non-hormonal anti-inflammatory drugs within 2 weeks and intravenous injection of indomethacin to investigate the contractile effect of this drug on coronary vessels. After the patient is supine, the arterial catheter is placed in the arm or femoral artery of the patient and connected to the microsensor for continuous measurement of arterial pressure. The thermodilution catheter was inserted into the coronary sinus via the brachial vein and the coronary blood flow of the loyal person was measured by continuous thermal dilution method. Intravenous indomethacin 0.5 mg / Kg before, and 20 minutes after the determination of the patient’s arterial blood pressure, coronary sinus blood flow and arterial-coronary sinus oxygen difference. Results After the injection of indomethacin, the mean arterial pressure increased from 99 ± 4 to 118 ± 5mmHg (P <0.005) and the cardiac oxygen demand increased from 10.6 ± 0.7 to 12.3 ± 0.9 mmHg × 10-3 / min (P <0.05). Coronary blood flow decreased by 39% (P <0.05). Mean arterial-coronary sinus blood oxygen difference increased by 29% (P <0.001) and mean coronary resistance increased by 73% (P <0.05). Discussion The regulatory mechanism of the coronary circulation is not fully understood, and neurological, hormonal, hemodynamic, and metabolic effects have been studied. Since Vane (1971) reported that indomethacin inhibits prostaglandin synthesis by blocking cyclodeoxygenase, there is much evidence for the regulatory effect of prostaglandins on coronary vessels. There is currently no data on the inhibition of prostaglandin synthesis by short-term intravenous infusion of indomethacin nor has this been determined