硝酸甘油、硝普钠、三磷酸腺苷三种药物用于控制性降压的临床比较

Effects of Induced Hypotension by TNG,SNP and ATP

36例择期手术术中需行控制性降压的病人随机分成三组,其中 TNG 组12例,SNP 组11例,ATP 组13例。降压期间观察到的各项变化有:MAP 分别比降压前下降26.01％(TNG)、28.42％(SNP)和30.57％(ATP);SV 分别减少24.42％(TNG,P<0.05)和28.15％(SNP,P<0.001);HR 分别增快21.20％(TNG,P<0.001)和21.60％(SNP,P<0.001);ATP 组的 SV 基本无变化,HR 增加9.9％(P>0.05);SNP 组血气分析的 BE 值负值增加;SNP 组和 ATP 组各有1例心电图 ST 段明显下降,停药复压后即恢复正常。结果表明:TNG 和 SNP 降压时前负荷降低,SV 下降 HR 增快,而 ATP 对 SV 和 HR 影响均不明显,似乎是个好的降压药物。

Thirty-six patients were randomly divided into three groups:TNG(n=12),SNP(n=11) and ATP(n=13) for con-trolled hypotension.MAP decreased by 26.01%(TNG),28.42%(SNP) and 30.57%(ATP).SV reduced by 24.42%(P<0.05) and 28.15%(P<0.001) with HR increased by 21.20%(P<0.001) and 21.60%(P<0.001) in TNG groupand SNP group.By contrast,in ATP group SV increased by 0.93% with HR increased by 9.9%(P>0.05).Blood-gasshowed a metabolic acidosis in SNP group.Transient S-T depression recorded in two cases(one in SNP,the other in TNG).Theresults indicate that hypotension induced by TNG and SNP would cause SV decrease and HR increase,while ATP having theadvantage of SV increase with no significant HR increase and seems a good drug for controlled hypotension.