血管紧张素ⅡⅠ型受体拮抗剂氯沙坦对急性心肌梗死的血流动力学效应  

The Hemodynamic Effects of Two Doses of Angiotensin Ⅱ Receptor Antagonist Losartan in Acute Myocardial Infarction

作　　者：王晓阳[1] 丁文惠[1] 吴林[1] 李建平[1] 高亢[2] 张钧华[1] 

机构地区：[1]北京医科大学第一医院心内科,北京100034 [2]北京复兴医院,北京100038

出　　处：《中国医药导刊》1999年第1期29-32,共4页Chinese Journal of Medicinal Guide

摘　　要：为观察口服氯沙坦(25mg,50mg)对急性心肌梗死患者的血流动力学效应,对10例急性心肌梗死患者放置漂浮导管,测量用药前及用药30min,1,2,3,4,6,9h时,收缩压(SBP)、舒张压(DBP)、平均动脉血压(MAP)、心率(HR)、外周血管阻力(SVR)、耗氧指数、心指数(CI)、肺毛压(PCWP)、左室每搏作功指数(LVSWI)、右房压(RAP)的变化。结果表明,服药后4h作用最明显,SBP、DBP、MAP、SVR、耗氧指数分别较用药前下降12％,11％,13％,14％和15％,25mg较50mg作用明显;CI轻度增加;HR、PCWP、RAP、LVSWI无明显变化。提示急性心肌梗死患者口服氯沙坦产生外周阻力及心肌耗氧量下降,心指数增加等有益的血流动力学效应。氯沙坦25mg较50mg效果更明显。下壁心肌梗死早期应用需慎重。The purpose of the present study was to assess the hemodynamic effects of two oral doses (25mg, 50mg ) of losartan in acute myocardial infarction (AMI ) .Ten patients with AMI were enrolled in this study, including eight patients with anterior infarction, two patients with inferior - posterior and right ventricular infarction. After baseline hemodynamic measurements using Swan Ganz catheters, ten patients received a single dose of 25mg losartan in one morning , and 50mg losartan in the next morning. Hemodynamic parameters were measured at 0.5, 1, 2, 3, 4, 6, 9 hours after medication. The largest hemodynamic changes were found at 4 hours after medication. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean artery pressure (MAP) systemic vascular resistance (SVR) and oxygen consumpt index fell 12% ,11% ,13% ,14% ,15% , respectively, with 25mg , but lesser decreases were seen with 50mg. Cardiac index (CI) rose slightly with both 25mg and 50mg . No obvious changes could be found with HR, PCWP, RAP and LVSWI. The results showed that oral losartan administrated to patients with AMI resulted in beneficial hemodynamic effects, such as decrease of SVR and oxygen consumption , increase of cardiac index. Greater effects were seen with 25mg than 50mg . Losartan should be carefully used in early acute inferior myocardial infarction .

关 键 词：氯沙坦 急性心肌梗死 血流动力学 血管紧张素转换酶抑制剂 

分 类 号：R972[医药卫生—药品]