THE ROLE OF HYDRALAZINE THERAPY FOR PULMONARY ARTERIAL-HYPERTENSION OF UNKNOWN CAUSE
THE ROLE OF HYDRALAZINE THERAPY FOR PULMONARY ARTERIAL-HYPERTENSION OF UNKNOWN CAUSE
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DOI：
10.1161/01.cir.65.4.645
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发表时间：
1982-01-01
期刊：
影响因子：
37.8
通讯作者：
BIALOSTOZKY, D
中科院分区：
文献类型：
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作者：
LUPIHERRERA, E;SANDOVAL, J;BIALOSTOZKY, D
对 12 名原因不明的肺动脉高压患者紧急给予肼屈嗪。所有患者均在休息时进行研究，9 名患者在运动时进行研究。根据静息时肼屈嗪反应，将患者分为两组。 6 名患者（A 组）的肺小动脉阻力 (Rp) 从 8.4.+- 下降。 1.4 至 4.8.+-。 1.4 U/m2 (P < 0.001)，心脏指数 (CI) 从 3.47 .+- 增加。 0.3 至 5.86.+-。每平方米 0.5 l/min (P < 0.005) 和系统阻力 (Rs) 从 25 .+- 下降。 4 至 14 .+-. 2U/m2（P<0.01）。使用肼屈嗪后，Rp/Rs 比率没有显着变化（0.32.+-.0.03 与 0.33.+-.0.07，NS [不显着]）。在其他 6 名患者（B 组）中，Rs 从 25.+- 下降。 2 至 17.0 .+-. 1 U/m2 (P < 0.01)，但其他变量没有显着变化。肼屈嗪的肺血管舒张作用明显引起A组右心室后负荷明显降低。B组出现明显的全身血管舒张作用，但右心室后负荷未降低。在既往血流动力学反应的基础上，仅A组患者接受口服肼屈嗪治疗（50 mg，每6 h）。肼苯哒嗪给药后 48 小时（休息时和运动时）以及 8 个月时重复进行血流动力学测量。后来，在 6 名患者中的 5 名患者中，有益的血流动力学效应持续存在。肼苯哒嗪明显降低了某些原因不明的肺动脉高压患者（肺动脉压<60mmHg，Rp<15U/m2，Rp/Rs比值<0.7）的Rp。
Hydralazine was administered acutely to 12 patients who had pulmonary arterial hypertension of unknown cause. All patients were studied at rest and 9 during exercise. On the basis of hydralazine response at rest, the patients were divided in 2 groups. In 6 patients (group A), pulmonary arteriolar resistance (Rp) decreased from 8.4 .+-. 1.4 to 4.8 .+-. 1.4 U/m2 (P < 0.001), cardiac index (CI) increased from 3.47 .+-. 0.3 to 5.86 .+-. 0.5 l/min per m2 (P < 0.005) and systemic resistance (Rs) decreased from 25 .+-. 4 to 14 .+-. 2 U/m2 (P < 0.01). The Rp/Rs ratio did not change significantly after hydralazine (0.32 .+-. 0.03 vs. 0.33 .+-. 0.07, NS [not significant]). In the other 6 patients (group B), Rs decreased from 25 .+-. 2 to 17.0 .+-. 1 U/m2 (P < 0.01) but the other variables did not change significantly. The pulmonary vasodilatory effect of hydralazine apparently caused a marked reduction in right ventricular afterload in group A. In group B, a marked systemic vasodilatory effect occurred and right ventricular afterload was not reduced. On the basis of the previous hemodynamic response, only group A patients were treated with oral hydralazine (50 mg every 6 h). Hemodynamic measurements were repeated 48 h after hydralazine, both at rest and during exercise, as well as 8 mo. later in 5 of the 6 patients in whom the beneficial hemodynamic effects persisted. Hydralazine apparently reduced Rp in selected patients (pulmonary arterial pressure < 60 mm Hg, Rp < 15 U/m2 and Rp/Rs ratio < 0.7) with pulmonary hypertension of unknown cause.