卡维地洛治疗高血压血流动力学的急性效应

The Acute Hemodynamic Effects after Carvedilol in Essential Hypertension Patients

用二维超声观察12例高血压病患者首次口服卡维地洛后其血流动力学的即刻效应。口服卡维地洛40mg，1h后降压有效率67％，血压平均下降2.8／1．6kPa（21／12mmHg），PSBP＜0．05，PDBP＜0．01。2h后降压有效率100％，血压平均下降3．9／2.1kPa（29／16mmHg），P＜0．01。超声心动图检查发现左心室收缩与舒张末期腔径减少（P＜0．05），心搏出量及总周围血管阻力降低（P＜0．05），平均周径纤维缩短率增加（P＜0．01），心率、心输出量、射血分数、左室小轴缩短率及左室重量指数无变化（P＞0．05）。提示卡维地洛具有动静脉扩张作用，同时改善左心室收缩功能。

Using two - dimensioned echocardiography techniques, the acute hemodynamic effects after carvedilol were assessed in 12 patients with stage Ⅰ-Ⅱ essential hypertension. Systolic and diastolic blood pressure significantly decreased in patients 1 hour after 40mg carvedilol, with mean blood pressure fell down 2.8/1.6kpa (PsBP＜0.05,PDBP＜0.01), its effective rate was 67%. After 2 hour,blood pressure reduction was 3.9/2.1kpa(Pboth＜0.01), the effective rate was 100%. Examination of echocardiography revealed that left ventricular diameters in diastole (LVDd)and systole (LVDs),stroke volume (SV) and total peripheral resistance (TRP) decreased (P＜0.05), but mean velocity of circumference fibre (MVCF) increased (P＜0.01). No significant changes of heart rate (HR), cardiac output (Co), ejection fraction (EF), fractional shortening (FS) and left ventricular mass index(LVMI)were discovered. These results suggest that carvedilol dilates arteries and veins simultaneously, and improves the left ventricular systolic function.