静脉滴注腺苷对风湿性心脏病合并肺动脉高压的血流动力学效应

Hemodynamic response of infusing adenosine in rheumatic heart disease with pulmonary hypertension

目的 观察中心静脉滴注腺苷对风湿性心脏病合并肺动脉高压患者瓣膜置换术后的治疗效果。方法 对 18例确诊为风湿性心脏病合并重度肺动脉高压患者 ,术后早期经中心静脉输注 5 0 μg·kg-1·min-1的腺苷 ,观察用药前后血流动力学参数和血气指标的变化。结果 与用药前相比 ,肺动脉平均压明显下降 (P <0 .0 5 ) ;肺血管阻力明显下降 (P <0 .0 5 ) ;心排血量显著增加 (P <0 .0 5 ) ;体动脉压力和心率无明显改变 ;血气指标亦无明显变化。结论 腺苷在一定剂量时能选择性扩张肺动脉血管 。

Objective To investigate the effectivness of adenosine infusion into the central vein on pulmonary hypertension of rheumatic heart disease after cardiocsurgery. Methods 18 cases of rheumatic heart disease with serious pulmonary hypertension were infused with adenosine 50 μg·kg -1 ·min -1 after operation, the hemodynamic changes were observed before and after treatment.Results Compared with the baseline data, adenosine produced significant pulmonary vasodilation. Mean pulmonary arterial pressure decreased obviously ( P <0.05) and pulmonary vascular resistance decreased significantly ( P <0.05). At the same time cardiac output increased greatly ( P <0.05). But there was no change in the mean systemic arterial pressure during adenosine infusion. Conclusion Adenosine may be used clinicly as a selective pulmonary vasodilating agent to optimize pulmonary hemodynamic indices without adverse effect on systemic hemodynamics.