腺酸心脏的第一阶段人体试验
S E Fremes1, S L Levy, G T Christakis
1Department of Pharmacy, University of Toronto, Canada. Stephen.Fremes@sunnybrook.utoronto.ca
Circulation
|November 1, 1996
概括
在心肺旁路术期间补充腺素对心脏手术患者来说是安全的. 建议使用15-25mmol/L的剂量进行进一步研究,以平衡疗效与潜在的低血压风险.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 药理学 药理学是指药理学的学科.
背景情况:
- 氨酸在缺血-再输液期间是众所周知的心脏保护.
- 由于潜在的低血压和AV阻塞,它在人类心脏的最佳剂量是不确定的.
- 之前的研究广泛探讨了腺在各种缺血-再输血模型中的作用.
研究的目的:
- 为了确定在冠状动脉旁路手术期间添加到心脏症溶液中的腺素的安全和适当剂量.
- 为了评估系统性低血压和心房 (AV) 阻塞在不同度的腺素的发生率.
主要方法:
- 一个开放的,非随机的第1期剂量范围研究在接受初级隔离冠状动脉旁路手术的患者中进行.
- 氨酸被添加到升级度 (0-50mmol/L起初,然后0-25mmol/L与修改的输送系统) 在升级的温血性心脏损伤前.
- 对于显著的低血压和AV阻塞,定义了停止规则,其中使用烯和节奏依赖是关键指标.
主要成果:
- 在最初的 4:1 血液到晶体性心脏系统中,多达 25 毫米/升的腺素剂量被很好地容忍.
- 50mmol/L的剂量导致了4名患者中的3名在心诱导期间显著的低血压.
- 在8:1系统中,诱导期间的低血压在15-25mmol/L时更为普遍,但不需要永久的节奏,并且在56名患者中没有发生心脏病发作或中风等重大不良事件.
结论:
- 在心脏外科手术中,在心肺旁路期间可以安全地注射腺素.
- 建议进行进一步的研究,使用15至25mmol/L的腺,具体剂量取决于心肌的输送系统.
- 这项研究为未来对腺在心脏手术中的临床实用性的研究提供了基础.
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