前列腺素E_1对先天性心脏病术后血流动力学的影响  

EFFECTS OF PROSTAGLANDIN E1 ON POSTOPERATIVE HEMODYNAMICS IN CHILDREN WITH CONGENITAL HEART DISEASE

作　　者：张朝阳[1,2] 陶萍[1,2] 朱兆仪[1,2] 孙兴昌 陈雷[1,2] 伍丽明 刘平[1,2] 

机构地区：[1]中国医学科学院 [2]中国协和医科大学阜外医院

出　　处：《中国临床药理学杂志》1997年第4期204-209,共6页The Chinese Journal of Clinical Pharmacology

摘　　要：本文观察了前列腺素Ｅ１（ＰＧＥ１）对术后有肺动脉高压的先天性心脏病患者的血流动力学影响，探索该药的剂量与效应的关系，为指导临床合理用药提供参考。术前通过右心导管、Ｘ线胸片、超声心动图等检查诊断为房缺，室缺，动脉导管未闭合并中度以上的肺动脉高压的患者，于术中放置Ｓｗａｎ－Ｇａｎｚ漂浮导管及桡动脉测压管，术后观察心率、桡动脉压、肺动脉压、右房压、肺毛压及血气。用热稀释法测定心输出量，计算心脏指数，心搏容积指数，肺循环和体循环阻力。ＰＧＥ１以１０，３０，５０，８０，１００，１２０，１５０ｎｇ·ｍｉｎ－１·ｋｇ－１静脉泵入时对上述指标的影响。结果示ＰＧＥ１能显著地降低肺动脉压，右房压，肺毛压，肺循环阻力，体循环阻力，增加心脏指数及动脉血氧分压，心率加快，体动脉压下降，效应与１０～１００ｎｇ·ｍｉｎ－１·ｋｇ－１相关性良好。结论：ＰＧＥ１是有效的血管扩张剂，对肺血管有相对选择性，改善心脏功能显著，宜中心静脉给药，从小剂量开始，适宜剂量在５０～１２０ｎｇ·ｍｉｎ－１·ｋｇ－１之间。Effects of PGE1 on postoperative hemodynamics and correlation between dose and effect were studied. Eight patients diagnosed as ASD,VSD, PDA with moderate pulmonary hypertension by right heart catheter,chest X-ray and echocardiography were selected. During operation, Swan-Ganz and radial arterial cannules were performed.After operation,heart rate, radial arterial pressure and arterial blood gas were monitored, cardiac output was measured by thermodilution technique,systemic vascular resistance, pulmonary vascular resistance and cardiac index were calculated from standard formula.These variables were measured again at dose 10,30,50,80,120,150 ng·min-1·kg-1 of PGE1. The results show that PGE1 reduces significantly pulmonary arterial pressure,pulmonary vascular resistance,systemic vascular resistance and systemic arterial pressure and increases heart rate, cardiac index and arterial oxygen tension. These effects are closely related to the 10-100 ng·min-1·kg-1 of PGE1.

关 键 词：肺动脉高压 前列腺素E1 先天性心脏病 手术后 

分 类 号：R543.205[医药卫生—心血管疾病] R654.2[医药卫生—内科学]