Eight patients with chronic obstructive lung disease (COLD) and pulmonary hypertension were given an infusion of a calcium antagonist, felodipine, during ongoing, long-term oxygen treatment (LTOT). The effects on central haemodynamics and ventilation-perfusion matching were studied. At rest pulmonary and systemic vascular resistances (PVR and SVR) were reduced by 18% (NS) and 26% (p less than 0.05), respectively. Cardiac output increased by 23%. There was a tendency to increased perfusion of low alveolar ventilation-perfusion ratio (VA/Q) areas (VA/Q less than 0.1) and to increased shunt compared to pretreatment values. Arterial oxygen tension (PaO2) fell by 0.7 kPa (p less than 0.001) but total oxygen transport increased by 23% (p less than 0.001). After treatment with oral felodipine (7.5-15 mg.day-1) for a mean time of 14 wks, PVR and SVR were reduced by 16% (p less than 0.05) and 7% (NS), respectively, as compared to pretreatment values at rest. Cardiac output rose by 13%. The VA/Q ratios and the PaO2 returned towards pretreatment values. The total oxygen transport increased by 11% (p less than 0.05) at rest and increased by 19% (p less than 0.05) during exercise as compared to the pretreatment value. The positive effect on central haemodynamics indicates that felodipine may be a valuable adjunct to ongoing LTOT.

译文

:在进行中的长期氧气治疗(LTOT)期间,向8位患有慢性阻塞性肺疾病(COLD)和肺动脉高压的患者输注了钙拮抗剂非洛地平。研究了对中央血流动力学和通气-灌注匹配的影响。静止时,肺和全身血管阻力(PVR和SVR)分别降低了18%(NS)和26%(p小于0.05)。心输出量增加了23%。与预处理值相比,低肺泡通气-灌注比(VA / Q)区域的灌注增加(VA / Q小于0.1),分流增加。动脉血氧张力(PaO2)下降了0.7 kPa(p小于0.001),但总氧输送增加了23%(p小于0.001)。与预处理相比,口服非洛地平(7.5-15 mg.day-1)平均治疗14周后,PVR和SVR分别降低了16%(p小于0.05)和7%(NS)。静止值。心输出量增长了13%。 VA / Q比和PaO2返回到预处理值。与治疗前的值相比,静止时的总氧气输送量增加了11%(p小于0.05),而在运动过程中的总氧气输送量增加了19%(p小于0.05)。对中枢血流动力学的积极影响表明,非洛地平可能是正在进行的LTOT的有价值的辅助药物。

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