BQ123及Phosphora midon单独及联合应用对心力衰竭患者的血管活性作用  

Vasoactive effect of seperated and combined treatment of BQ123 and Phosphoramidan in CHF patients

作　　者：严晓伟[1] Wolfgang Kiowski 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院心脏内科,北京100730 [2]瑞士苏黎世大学医院心脏内科

出　　处：《基础医学与临床》2001年第2期154-157,共4页Basic and Clinical Medicine

摘　　要：在阻断内皮素A受体 (ET A)的基础上 ,观察内皮素转化酶 (ECE)抑制剂对血管舒缩功能的影响。 12例心力衰竭患者及 12例正常志愿者 ,在用BQ12 3阻断ET A的基础上 ,接受ECE抑制剂Phosphoramidon ,观察前臂血流量 (FBF)的变化。经肱动脉注射BQ12 3后 ,FBF均呈相同程度升高。随后注射Phosphoramidon使FBF均进一步增加。但在心力衰竭患者 ,BQ12 3的作用时间明显短于正常人。提示在阻断ET A受体的基础上 ,抑制ET的合成可产生进一步的扩血管作用。BQ12 3在心力衰竭患者的作用时间明显缩短 ,表明药物在体内被高浓度的ET迅速置换。On the basis of complete blockade of endothelin A (ET A) receptor, the hemodynamic effects of further removal of endothelin B receptor mediated effect with endothelin converting enzyme is not clear We studied forearm vasodilation (with plethysmography) during a maximally effective dose of an ET A receptor antagonist alone (brachial artery infusion of BQ123, 36μg/min·100mL tissue for 25min) and during double blind, randomized, additional endothelin converting enzyme inhibition (phosphoramidon, 20μg/min·100mL tissue for 15min, n=6) or placebo (n=6) in 12 patients with severe congestive heart failure (CHF) Baseline clinical characteristics in terms of age, NYHA grade, LVEF and medications are comparable between the two groups As a study control, we carried out the same protocol in 12 normal volunteers Forearm blood flow (FBF) increased similarly in patient with CHF and in normal volunteers after BQ123 over the 45 min observation period There were significant further increases of FBF in both study populations after phosphoramidon infusion While in placebo treated CHF patients during the additional 45min observation period, there is a decrease of FBF by a mean of 30% (mean difference between Phosph and Pla 57%, 95% CI 43 to 72%, P <0 001), which was greater than that in normal subjects In patients with severe CHF as well as in normal volunteers, endothelin converting enzyme inhibition results in further vasodilation on the basis of ET A receptor blockade alone, which suggests that ET B receptor may play a role in maintaining vascular tong in human beings

关 键 词：内皮素受体 内皮素转化酶抑制剂 前臂体积描记 心力衰竭 血管活性作用 

分 类 号：R541.6[医药卫生—心血管疾病]