尼莫地平对动脉压力感受器反射的影响

Effect of nimodipine on arterial baroreflex in humans

目的 :探讨尼莫地平 (nimodipine)对动脉压力感受器反射的影响。方法 :2 0例 ASA I～ II级、拟在全麻下施行胆囊切除手术的患者 ,随机分为尼莫地平组 (NM组 )和对照组 (C组 ) ,每组 10例。在麻醉前及麻醉手术开始后分别静注新福林或硝酸甘油进行加压试验或减压试验。观察用药前后血压、心率的变化。用心动周期和动脉收缩压变化量的线性回归斜率来反映动脉压力感受器反射敏感度。结果 :在 C组患者 ,加压反射的斜率由麻醉前的 89.1m s/k Pa降到麻醉手术期的 46 .9ms/ k Pa(P<0 .0 5 ) ,减压反射的斜率由麻醉前的 81.9m s/ k Pa降到麻醉手术期的 36 .7ms/ k Pa(P<0 .0 5 ) ;NM组患者 ,加压反射和减压反射的斜率分别由麻醉前的 5 5 .9ms/ k Pa和 5 7.4m s/ k Pa降到麻醉手术期的 31.2 ms/ k Pa和 2 3.5 ms/ k Pa(均 P<0 .0 5 ) ;NM组患者在麻醉前、麻醉手术期的加压反射和减压反射的斜率与 C组患者比较均有轻微的降低 ,但无统计学显著性。结论 :小剂量尼莫地平对动脉压力感受器反射有轻度抑制作用。

AIM: To study the effect of nimodipine on arterial baroreflex. METHODS: Twenty patients with ASA physical status I^II, scheduled for cholestectomy under general anesthesia, were randomly divided into nimodipine group (Group NM, n =10) and control group (Group C, n =10). Pressor test and depressor test with intravenous phenylephrine and nitroglycerin were carried out both before and anesthesia and during the operation, and changes in arterial blood pressure, heart rate were also recorded.Arterial baroslope was acquired by line regression of R R interval from electrocardiogram and changes in arterial systolic blood pressure.RESULTS: In Group C and group NM the baroslope of pressor test decreased from 89.1 ms·kPa -1 and 55.9 ms·kPa -1 before anesthesia to 46.9 ms·kPa -1 and 31.2 ms·kPa -1 during operation respectively( P <0.05), and the baroslope of depressor test decreased from 81.9 ms·kPa -1 and 57.4 ms·kPa -1 before anesthesia to 36.7 ms·kPa -1 and 23.5 ms·kPa -1 during operation respectively( P <0.05); The baroslope of pressor test and depressor test before anesthesia and during operation were both slightly decreased in Group NM, compared with that in Group C, but with no statistically significance. CONCLUSION: A small dose of nimodipine had a slight inhibitive action on arterial baroslope. Clinical dose of nimodipine could be safely used during anesthesia and operation period.