β-上腺体阻塞增加肺血管阻力,并在高海拔地区引起过度低氧性肺血管收缩:一项生理学研究
Matthias Peter Hilty1, Christoph Siebenmann2,3, Peter Rasmussen2
1Institute of Intensive Care Medicine, University Hospital of Zurich, ZH 8091, Switzerland.
European heart journal. Cardiovascular pharmacotherapy
|January 12, 2024
概括
像普拉诺洛尔这样的β阻塞剂增加了肺动脉的压力和阻力,特别是在高海拔地区. 用糖烯酸盐阻断肌肉蛋白对抗这些效应,这表明登山者服用β-阻断剂的后果.
科学领域:
- 心血管生理学心血管生理学
- 高度医学 高度医学
- 自主神经系统药理学 自主神经系统药理学
背景情况:
- 使用β抑制剂的高血压患者前往高海拔地区 (HA).
- 缺氧会增加肺动脉压力 (Ppa) 和阻力 (PVR),但自主神经系统的作用尚不清楚.
- 动物研究表明,β阻塞诱导肺血管收缩,因低氧过大,效应被肌肉蛋白阻塞消除.
研究的目的:
- 假设propranolol (PROP) 增加了Ppa和PVR在normxia和夸大了缺氧肺血管收缩 (HPV).
- 调查glycopyrrolate (GLYC) 是否消除了PROP对Ppa,PVR和HPV的影响.
- 评估自主封锁对肺血液动力学和船只在海平面和高海拔上的延伸能力的影响.
主要方法:
- 在3周后在海平面 (SL) 和高海拔 (HA) 上对7名健康男性进行侵入性Ppa测量.
- 没有药物,用PROP和PROP + GLYC进行的测量.
- 使用大腿手释放机动评估的肺压力-流量关系和血管延展性.
主要成果:
- 在SL,PROP使Ppa增加了21%,PVR增加了57%.
- 在HA时,PROP的PVR增加被放大到76%.
- PROP + GLYC消除了PROP对Ppa和PVR的影响;这两种自主阻塞都降低了肺血管延伸能力.
结论:
- β-上腺素阻塞增加PVR,而肌阻塞降低PVR;两者都增加了肺动脉弹性.
- β-上腺体阻断会夸大HPV,这对服用β-阻断剂的登山者管理有影响.
- 这些发现突出了自主神经系统在HA暴露期间调节肺循环中的作用.
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