Clinical application of diadenosine tetraphosphate (Ap4A:F-1500) for controlled hypotension
Clinical application of diadenosine tetraphosphate (Ap4A:F-1500) for controlled hypotension
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DOI：
10.1034/j.1399-6576.1999.430117.x
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发表时间：
1999-01-01
影响因子：
2.1
通讯作者：
Haruki, S
中科院分区：
文献类型：
--
作者：
Kikuta, Y;Ohiwa, E;Haruki, S
背景资料：在我们的动物研究中，发现二腺苷四磷酸（Ap（4）A：F-1500）具有剂量依赖性降压作用，与对照值相比，平均动脉压降低高达60%。此外，在健康男性志愿者中，Ap 4A高达4 mg min（-1）的安全性得到证实。在全麻下手术的病人中，应用Ap 4A控制性降压，观察其降压效果及对血压的调节作用。方法：对10例全麻下择期手术的病人进行控制性降压研究。用异氟烷（n=7）或七氟烷（n=3）在氧-氧化亚氮中维持麻醉。以10-20 μ g kg（-1）min-1的速率给予Ap 4A诱导控制性降压。以80 μ g kg（-1）min（-1）的最大速率调整剂量，直至达到目标血压。监测动脉血压和心率。在4个不同的时间点抽取动脉样品以测量血浆中Ap 4A的浓度。开始Ap（4）A输注后达到目标血压所需的时间约为16分钟，停药至血压恢复时间约18 min，Ap（4）输注过程中未出现反射性心动过速停药后无明显反跳性高血压。血浆Ap（4）A浓度随Ap（4）A给药速率的加快而升高，并有增强降压作用的趋势。结论：由于Ap（4）A具有良好的降压作用和血压调节作用，故可用于控制性降压。
Background: In our animal study, it was revealed that diadenosine tetraphosphate (Ap(4)A:F-1500) has a dose-dependent hypotension effect of up to 60% decrease in mean arterial pressure compared to control value. Furthermore, in healthy male volunteers, the safety of Ap4A up to 4 mg min(-1) was confirmed. In patients who require surgical procedures under general anesthesia together with controlled hypotension, hypotension was induced by Ap4A in order to examine its hypotensive effect and modulating action on the blood pressure.Methods: Ten patients who required controlled hypotension and who were scheduled for elective surgery under general anesthesia were studied. Anesthesia was maintained with isoflurane (n=7) or sevoflurane(n=3) in oxygen-nitrous oxide. Controlled hypotension was induced by Ap4A administered at a rate of 10-20 mu g kg(-1) min-l. The dose was adjusted at a maximum rate of 80 mu g kg(-1) min(-1) until the target blood pressure was achieved. Arterial blood pressure and heart rate were monitored. Arterial samples were drawn at 4 separate time points to measure the concentration of Ap4A in the plasma.Results: The time required for attaining the target blood pressure after initiation of Ap(4)A infusion was about 16 min, and the time lapse between withdrawal of infusion to recovery of blood pressure was about 18 min. No reflex tachycardia was observed during infusion of Ap(4)A and no rebound hypertension was evident after withdrawal. The plasma Ap(4)A concentration increased in response to the acceleration rate of Ap(4)A administration with a tendency of augmented hypotensive effect.Conclusion: As it produces an excellent hypotensive effect together with a modulating action on blood pressure, AP(4)A was assessed as useful in producing controlled hypotension.