奈比洛尔、卡维地洛尔和心得安对实验性肺血栓栓塞兔肺微血流动力学的影响

V. I. Evlakhov, I. Z. Poyassov, T. P. Berezina
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摘要

背景:β -肾上腺素阻滞剂奈比洛尔、卡维地洛尔和心得安在临床心脏病学中用于缺血性心脏病患者的治疗。这类患者可发生肺血栓栓塞。然而,在肺血栓栓塞的情况下,β受体阻滞剂预处理后的肺微循环变化是未知的。目的:比较分析纳波洛尔、卡维地洛尔和心得安预处理后实验性肺血栓栓塞兔肺微血流动力学的变化。材料与方法:对35只离体兔肺进行灌注,研究1-受体阻滞剂奈比洛、1-和1,2 -肾上腺素受体阻滞剂卡维地洛和1,2 -肾上腺素受体阻滞剂普萘洛尔预处理后实验性肺血栓栓塞时肺微循环的变化。结果:1,2 -肾上腺素受体阻滞剂普萘洛尔和1-受体阻滞剂奈比洛尔给药后,肺微循环参数大部分升高。联用1-,1,2 -阻滞剂卡维地洛主要引起肺动脉血管的扩张作用,但肺静脉阻力增加。β受体阻滞剂预处理后的肺血栓栓塞引起肺动脉压、毛细血管前和肺血管阻力明显升高。卡维地洛预处理后毛细血管过滤系数比普萘洛尔预处理后提高2倍;纳比洛尔预处理后毛细血管过滤系数比普萘洛尔处理后的增加幅度小。结论:与卡维地洛和心得安预处理相比,纳比洛尔对急性肺栓塞患者毛细血管滤过系数的升高不明显。
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The impact of nebivolol, carvedilol and propranolol on pulmonary microhemodynamics in case of experimental pulmonary thromboembolism in rabbits
BACKGROUND: Beta-adrenoblockers nebivolol, carvedilol and propranolol are used in clinical cardiology for the treatment of patients with ischemic heart disease. Pulmonary thromboembolism can develop in such patients. However, its unknown, what will be the pulmonary microcirculatory changes in case of pulmonary thromboembolism after pretreatment with beta-blockers. AIM: The comparative analysis of the pulmonary microhemodynamics changes following experimental pulmonary thromboembolism in rabbits after pretreatment with nebovolol, carvedilol and propranolol. MATERIAL AND METHODS: In 35 isolated perfused rabbit lungs we investigated the changes of pulmonary microcirculation in case of experimental pulmonary thromboembolism after pretreatment with 1-blocker nebivolol, combined blocker of 1- and 1, 2-adrenoceptors carvedilol, and blocker of 1, 2-adrenoceptors propranolol. RESULTS: After administration of 1, 2-adrenoceptors blocker propranolol and 1-blocker nebivolol the most of the pulmonary microcirculatory parameters increased. Combined 1-, 1, 2-blocker carvedilol caused mainly vasodilatory effects of the pulmonary arterial vessels, however, the pulmonary venous resistance increased. Pulmonary thromboembolism after pretreatment with beta-blockers caused pronounced increase of pulmonary artery pressure, precapillary and pulmonary vascular resistance. In that case after pretreatment with carvedilol capillary filtration coefficient was increased two times more than after propranolol administration; after pretreatment with nebivolol capillary filtration coefficient increased less, than after propranolol administration. CONCLUSIONS: Acute pulmonary embolism caused less pronounced increasing of capillary filtration coefficient in case of nebivolol administration, than after pretreatment with carvedilol and propranolol.
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