RENAL EFFECTS OF NITROPRUSSIDE AND HYDRALAZINE IN PATIENTS WITH CONGESTIVE HEART-FAILURE
RENAL EFFECTS OF NITROPRUSSIDE AND HYDRALAZINE IN PATIENTS WITH CONGESTIVE HEART-FAILURE
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DOI：
10.1161/01.cir.61.2.316
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发表时间：
1980-01-01
期刊：
影响因子：
37.8
通讯作者：
RAPAPORT, E
中科院分区：
文献类型：
--
作者：
COGAN, JJ;HUMPHREYS, MH;RAPAPORT, E
本文观察了硝普钠静脉滴注和肼苯哒嗪静脉滴注对9例男性严重低心排充血性心力衰竭（CHF）患者肾血流动力学和肾功能的急性影响。两种药物均引起全身血流动力学显著改善。硝普钠对肺动脉压有更深远的影响，而肼苯哒嗪产生更大的心输出量升高。两种药物均显著降低了体循环和肺血管阻力以及肺毛细血管楔压，同时增加了每搏输出量和每搏作功指数。两种药物均可降低肾总阻力，显著增加肾血流量（RBF），而心输出量向肾脏的分布仍受抑制。肾小球滤过率（GFR）在任何一种药物下均无显著变化，但在选定的患者中观察到GFR增加，其中RBF较对照组增加> 10%。两种药物的血浆滤过分数均降至正常水平，总阳离子排泄量显著增加。这些变化都代表了CHF患者发生的全身和肾脏血流动力学异常的改善;在长期治疗期间维持这些变化将有助于患者管理。
The acute effects of nitroprusside infusion and i.v. hydralazine on renal hemodynamics and function were evaluated in 9 male patients with severe, low cardiac output, congestive heart failure (CHF). Both drugs caused marked systemic hemodynamic improvement. Nitroprusside had a more profound effect on pulmonary artery pressure, while hydralazine produced a greater elevation in cardiac output. Significant decreases in both systemic and pulmonary vascular resistance and pulmonary capillary wedge pressure with increases in stroke volume and stroke work index were noted with both drugs. Total renal resistance decreased and renal blood flow (RBF) significantly increased with both drugs, while the distribution of cardiac output to the kidney remained depressed. Glomerular filtration rate (GFR) did not change significantly with either drug, but increases in GFR were seen in selected patients in whom RBF increased by > 10% from control. The fraction of plasma filtered decreased toward normal with both drugs and excretion of total cations was significantly increased. The changes all represent improvements in systemic and renal hemodynamic abnormalities occurring in patients with CHF; their maintenance during long-term therapy would facilitate patient management.