Japanese
English
- 有料閲覧
- Abstract 文献概要
- 1ページ目 Look Inside
抗コリン薬高用量追加吸入が肺循環動態に及ぼす影響を検討した．Oxitropitun投与中の安定期慢性閉塞性肺疾患患者20例に右心カテーテルを留置し，Oxitropiuni 1,200μg吸入前と吸入1時間後に肺循環諸指標，血液ガス，血中ノルアドレナリン濃度，エンドセリン濃度を測定した．高用量吸入後に肺動脈圧，右房圧，肺毛細管楔入圧，総肺血管抵抗は有意に低下したが，体血圧，心拍数，体血管抵抗，動脈血pCO2，は変化がなかった。指尖脈波酸素飽和度，肺動脈コンプライアンスは有意に増加した．血中ノルアドレナリン濃度は低下傾向を示し，エンドセリン濃度は低下した。吸入後の肺動脈圧はノルアドレナリンの減少に沿って低下したが，エンドセリン高値例では解離がみられた．抗コリン薬高用量追加吸入は呼吸機能のみならず肺循環をも改善する可能性が示された．
To evaluate the effect of high dose inhalation of the anticholinergic agent, oxitropium bromide, on pulmo-nary circulation, right heart catheterization was carried out in twenty patients with chronic obstructive pulmo-nary disease (COPD). In the stable status of COPD, pulmonary hemodynamics, arterial blood gases, plasma concentration of noradrenaline and endotheline were measured in the supine position before and 60 minutes after inhalation of 1,200μg of oxitropium. The results were as follows.
1) Oxitropium did not significantly change the sys-temic blood pressure, the heart rate, pCO2, the cardiac output or the systemic vascular resistance. However, after high dose inhalation of oxitropium, the mean arterial pressure, the mean right atrial pressure, the mean pulmonary capillary wedge pressure and total pulmonary vascular resistance decreased significantly. The oxygen saturation of the peripheral arterial pulse wave and pulmonary arterial compliance increased significantly after inhalation.
2) High dose inhalation of oxitropium showed a ten-dency to decrease the plasma concentration of nor-adrenaline, while the plasma concentration of endoth-eline decreased significantly after inhalation.
3) The mean pulmonary arterial pressure decreased lineally with the decrease of plasma noradrenaline, but not with the decrease of plasma endotheline.
It is concluded that high dose inhalation of this anti-cholinergic drug has not only the effect of bronchodila-don, but also beneficial effect on right heart overload.
Copyright © 1998, Igaku-Shoin Ltd. All rights reserved.
