卡维地洛治疗原发性高血压的急性血流动力学研究

Studies on the acute hemodynamic effects of carvedilol in patients with essential hypertension

目的:研究原发性高血压患者首次po卡维地洛后血流动力学的即刻效应。方法:8例原发性高血压患者,用二维超声心动仪测定给药前后的左心室功能,计算血流动力学参数。结果:po卡维地洛40mg,1h后血压即显著下降,血压平均下降1.3/0.9kPa,服药后2h血压下降幅度更大,平均下降2.5/1.6kPa(PSBP<0.01,PDBP<0.05),下降幅度SBP为12.5%,DBP为11.5%。服药后2h心率下降4次/分,有显著性差异(P<0.01)。超声心动图检查发现左心室舒张末期内径减少(P<0.05),平均周经纤维缩短率增加(P<0.01),射血分数上升(P<0.05)。左心室收缩末期内径、心搏出量、心输出量、左室重指数及总外周血管阻力均有下降,但不显著(P>0.05)。结论:卡维地洛有明显的降压作用,能改善急性血流动力学,提高左心功能。

OBJECTIVE:To study the acute hemodynamic effects after first dose carvedilol in patients with essential hypertension.METHODS:Eight patients with stageⅠ Ⅱ essential hypertension were treated with carvedilol.Using two dimensioned echocardiography techniques,function of left ventricule and hemodynamics were assessed.RESULTS:Systolic and diastolic blood pressure significantly decreased in patients 1 hour after 40 mg carvedilol,with mean pressure falling down 1.3/0.9 kPa.After 2 hour,blood pressure decreased more significantly with a reduction of 2.5/1.6 kPa ( P SBP <0.01, P DBP <0.05).The heart rate was also decreased significantly after 2 hour.Examination of echocardiography revealed that left ventricular diameters in diastole (LVDd) decreased ( P < 0.05 ),but mean velocity of circumference fibre (MVCF) and ejection fraction (EF) increased ( P MVCF <0.01, P EF <0.05).No significant decrease of left ventricular diameter in systole (LVDs),left ventricular mass index (LVMI),cardiac output (CO),stroke volume (SV) and total peripheral resistance (TRP) were discovered.CONCLUSION:These results suggested that carvedilol may have significant antihypertension effect,and can improve the acute hemodynamics in addition to the function of left ventricule.