The Effect of Ergotamine and Dihydroergotamine on Cerebral Blood Flow in Man
The Effect of Ergotamine and Dihydroergotamine on Cerebral Blood Flow in Man
复制标题
麦角胺和二氢麦角胺对人脑血流的影响
作者：
A. Andersen;P. Tfelt
静脉注射麦角胺和双氢麦角胺4小时后，研究其对脑血的影响，因为这些药物可能对偏头痛治疗有重要意义。8名正常男性志愿者（未患偏头痛）静脉注射0.5 mg麦角胺和1 mg双氢麦角胺。在静脉注射乙酰唑胺（1 g）前后，通过氙-133吸入法和单光子发射计算机断层扫描测量脑血流量。在麦角胺和双氢麦角胺给药前和给药后4小时测量脑血流量。应变仪测量趾臂收缩压差用于监测药物对腿部动脉的影响。两种药物给药后的平均半球和局部脑血流量均无变化（平均值± SEM，ml/100 g/min）：麦角胺给药前为57 ± 3，给药4小时为57 ± 3;双氢麦角胺给药前为54 ± 2，给药4小时为55 ± 2。乙酰唑胺的反应也没有变化。只有麦角胺显著降低趾臂收缩压差（240分钟后最大为22 mm Hg; p < 0.02）。因此，我们的研究并不支持在典型偏头痛发作期间应停止患者服用麦角生物碱的观点，但这需要进一步研究。麦角胺和双氢麦角胺外周效应的差异也可能具有临床意义。（中风1987;18：120-123）
The effects of ergotamine and dihydroergotamine on cerebral blood now was investigated 4 hours after i.v. injection as these drugs might be of importance for migraine treatment. Eight normal male volunteers (not suffering from migraine) received 0.5 mg ergotamine and 1 mg dihydroergotamine i.v. Cerebral blood flow was measured by the xenon‐133 inhalation method and single—photon—emission computerized tomography before and after intravenous acetazolamide administration (1 g). Cerebral blood flow was measured before and 4 hours after ergotamine and dihydroergotamine administration. Strain—gauge measurements of toe—arm systolic gradients were used to monitor the effect of the drug on leg arteries. Mean hemispheric and regional cerebral blood flow was unchanged after either drug (mean ± SEM, ml/100 g/min): for ergotamine, 57 ± 3 before and 57 ± 3 at 4 hours; for dihydroergotamine, 54 ± 2 before and 55 ± 2 at 4 hours. The acetazolamide response was unchanged as well. Only ergotamine decreased the toe—arm systolic gradient significantly (22 mm Hg at maximum after 240 minutes; p < 0.02). Thus, our study did not support the belief that ergot alkaloids should be withheld from patients during attacks of classic migraine, but this has to be investigated further. The discrepancy in the peripheral effects of ergotamine and dihydroergotamine might also be of clinical Importance. (Stroke 1987;18:120–123)