青心酮对慢性阻塞性肺病肺循环的选择性作用及血浆肾素、血管紧张素Ⅱ水平变化

Selective Effect of 3,4-dihydroxyacetophenone on Pulmonary Circulation in Patients with Chronic Obstructive Pulmonary Disease

通过Ｓｗａｎ－Ｇａｎｚ导管法测定１１例慢性阻塞性肺病（ＣＯＰＤ）患者应用青心酮前后血流动力学的变化，同时采用放射免疫分析法测定血浆肾素活性（ＰＲＡ）、血管紧张素Ⅱ（ＡⅡ）含量。结果发现：用药后肺动脉平均压（ＰＡＰｍ）、肺循环阻力（ＰＶＲ）及体循环阻力（ＳＶＲ）均下降，但ＰＶＲ下降程度甚于ＳＶＲ，体动脉平均压（ＳＡＰｍ）及血氧饱和度无变化；ＰＲＡ、ＡⅡ含量均下降。直线相关分析表明，用药前后血浆ＰＲＡ、ＡⅡ水平与ＰＶＲ呈正相关。本研究表明，青心酮对肺循环的作用有一定的选择性，其降低肺血管阻力作用可能与肾素、ＡⅡ血浆水平下降有关。

Eleven patients with chronic obstructive pulmonary disease(COPD)at the stable stage treated with 3,4-dihydroxyacetophenone(DHAP)were examined with a right heart catheterization to obtain some hemodynamics parameters,Plasma renin activity(PRA)and angiotensin Ⅱ(AⅡ)levels were measured With radioimmunossay.The results showed that 640 mg DHAP given intravenously could decrease mean pulmonary arterial pressure(PAP),pulmonary vascular resistance(PVR)and systemic vascular resistance(SVR);PVR being decreased more significantly than SVR. However,the systemic arterial pressure(SAP)and blood gas analysis were not influenced.After the administration of DHAP, PRA and A Ⅱ levels were also decreased.There were strong correlations between the changes of PRA and A Ⅱ and those of PVR,SVR. This study suggests that DHAP has a selective effect on pulmonary circulation in patients with COPD, It is possible that the mechanism of its effect is related to the lowering of plasma PRA and A Ⅱ levels.