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

在正在进行的长期氧气治疗 (LTOT) 期间,对8名患有慢性阻塞性肺疾病 (COLD) 和肺动脉高压的患者进行了钙拮抗剂非洛地平的输注。研究了对中心血流动力学和通气-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) 和分流增加的趋势。动脉血氧张力 (PaO2) 下降了0.7 kPa (p小于0.001),但总输氧增加了23% (p小于0.001)。在用口服非洛地平 (7.5-15 mg.day-1) 治疗14 wks的平均时间后,与休息时的预处理值相比,PVR和SVR分别降低了16% (p小于0.05) 和7% (NS)。心输出量上升了13%。VA/Q比和PaO2返回预处理值。与预处理值相比,总氧传输在静止时增加11% (p小于0.05),在运动期间增加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的有价值的辅助手段。

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