摘要
目的：通过测量桡动脉波定量硝酸甘油降低中心动脉反射波增压的效应。方法：１９名志愿者，年龄５４±７岁，无严重器质性疾病，试验前停用所有心血管药物至少３天，试验当天禁食。先测基础仰卧位肱动脉血压和桡动脉脉搏波，随后随机贴上安慰剂或 ５ ｍｇ硝酸甘油贴剂，每隔半小时以同样的方式记录血压和脉搏波，共 ５个小时后撕去贴膜，再记录 ２ 小时。动脉脉搏波分析仪实时把桡动脉脉搏波换算为中心动脉脉搏波，显示中心动脉反射波增压（ＡＵＧ）和中心动脉反射波增压指数（ＡＩ）。结果：安慰剂组（９例），用药前后比较，心率（ＨＲ），射血时间（ＥＤ），肱动脉收缩压（ＰＳＰ），肱动脉舒张压（ＰＤＰ）和肱动脉平均压（ＰＭＰ）及计算的中心动脉波增压、增压指数、中心动脉收缩压等各项参数均无显著变化。 ５ ｍｇ硝酸甘油贴剂组 （ １０例）用药前后比较，射血时程、中心动脉波增压、增压指数、中心动脉收缩压在用药后半小时即显著下降，至３．５小时达高峰，撕去贴膜后２小时恢复到基础水平，但心率、肱动脉收缩压、肱动脉舒张压和肱动脉平均压无明显变化。结论：通过分析桡动脉脉搏波，可以定量中心动脉反射波增压，阐明硝酸甘油的作用，显示其起效、维持、撤除的动态变化。
to quantify the GTN action by measuring change in augmented aortic pressure caused by reduction in wave reflection. Methods: Glyceryl trinitrate patches 0 mg and 5 mg, in random fashion, were applied to 19 fasting volunteers, aged 54± 7 years, all other cardiovascular medications were discontinued for at least three days. The patches were applied for 5 hours and brachial arterial pressure, tonometric radial arterial pulses were measured. Half hour intervals up to 2 hours after the patch were removed. The recumbent, and central aortic pressure augmentation (AUG ) and central aortic pressure augmentation index (AI = central augmentation/aortic pulse pressure) were derived by sphygmo-Cor system. Results: In placebo group (n=9 ), there was no significant difference in all hemodynamic parameters, between control condition and placebo patch application, including heart rate (HR ), ejection duration (ED ), brachial systolic pressure (PSP) or diastolic pressure (PDP) or mean pressure (PMP), and calculated aortic AUG, Al and systolic pressure(CSP). 5 mg GNT patch (n = 10) caused significant decrease in ED, AUG, AI and CSP with apparent effect 0. 5 hours after patch application and maximal at 3. 5 hours. The parameters were returned to baseline 2 hours after patch removal. The were no significant changes in HR,PSP,PDP and PMP. Conclusion: Analysis of the radial artery pulse wave with measurement of central aortic augmentation can be used to demonstrate the effect of glyceryl trinitrate. The study shows the speed of onset and offset of action after application and removal of a GTN patch, and demonstrates the beneficial actions of GTN which is accompanied by changes in arterial pressure wave contour. The changes in peripheral arteries wave contour may be attributable to the reduction in peripheral wave reflection.
出处
《高血压杂志》
CSCD
2000年第1期17-20,共4页
Chinese Journal of Hypertension
关键词
硝酸甘油
脉博波分析
中心动脉压
glyceryl trinitrate
pulse wave analysis
central aortic augmentation
