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phentolamine

心血管

关键词心血管 药物 短效的非选择性α受体阻滞剂

词汇介绍

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解析

phentolamine  [fen'tɒləmiːn]  

释义   n. 酚妥拉明,芬妥胺(一种肾上腺素阻滞剂)

例句   Objective: To observe the effectiveness of Phentolamine and Dobutamine treating Chronic Pulmonary heart with the serious heart failure.  目的:观察酚妥拉明与多巴酚丁胺合用对肺心病合并严重心衰的治疗效果。


概述

药理作用短效的非选择性α受体阻滞剂,对α1、α2受体均有作用,能拮抗血液循环中肾上腺素和去甲肾上腺素的作用,使血管扩张而降低周围血管阻力;拮抗儿茶酚胺效应,用于诊治嗜铬细胞瘤,但对正常人或原发性高血压患者的血压影响甚少;能降低外周血管阻力,使心脏后负荷降低,左心室舒张末压和肺动脉压下降,心搏出量增加,可用于治疗心力衰竭。适应证1、预防和治疗嗜铬细胞瘤所致的高血压发作,包括手术切除时出现的阵发性高血压,也用于协助诊断嗜铬细胞瘤。2、预防和治疗因去甲肾上腺素静脉给药外溢而引起的皮肤坏死。3、心力衰竭

Impaired neuronal nitric oxide synthase-mediated vasodilator responses to mental stress in essential hypertension.复制标题

原发性高血压患者精神应激时神经元型一氧化氮合酶介导的血管舒张反应受损。

发表时间:2015-04-12

影响因子:7.0

作者: Sitara G. Khan

期刊:Hypertension

Neuronal NO synthase (nNOS) regulates blood flow in resistance vasculature at rest and during mental stress.To investigate whether nNOS signaling is dysfunctional in essential hypertension, forearm blood flow responses to mental stress were examined in 88 subjects: 48 with essential hypertension (42±14 years; blood pressure, 141±17/85±15 mmHg; mean±SD) and 40 normotensive controls (38±14 years; 117±13/74±9 mmHg). A subsample of 34 subjects (17 hypertensive) participated in a single blind 2-phase crossover study, in which placebo or sildenafl 50 mg PO was administered before an intrabrachial artery infusion of the selective nNOS inhibitor S-methyl-l-thiocitrulline (SMTC,0.05, 0.1, and 0.2 μmol/min) at rest and during mental stress. In a further subsample (n=21) with an impaired blood flow response to mental stress, responses were measured in the presence and absence of the α-adrenergic antagonist phentolamine. The blood flow response to mental stress was impaired in hypertensive compared with normotensive subjects (37±7% versus 70±8% increase over baseline; P<0.001). SMTC blunted responses to mental stress in normotensive but not in hypertensive subjects (reduction of 40±11% versus 3.0±14%, respectively, P=0.01, between groups). Sildenafl reduced the blood flow response to stress in normotensive subjects from 89±14% to 43±14% (P<0.03) but had no signifcant effect in hypertensive subjects. Phentolamine augmented impaired blood flow responses to mental stress from 39±8% to 67±13% (P<0.02). Essential hypertension is associated with impaired mental stress–induced nNOS-mediated vasodilator responses; this may relate to increased sympathetic outflow in hypertension. nNOS dysfunction may impair vascular homeostasis in essential hypertension and contribute to stress-induced cardiovascular events.

译文

神经元一氧化氮合酶(nNOS)调节休息和精神压力时抵抗血管的血流。为调查原发性高血压中nNOS信号是否功能异常,对88名受试者的前臂血流对精神压力的反应进行了检查:48名原发性高血压(42± 14岁;血压141±17/85±15 mmHg;平均值±SD)和40名血压正常对照者(38±14岁; 117±13/74±9 mmHg)。 34位受试者(17位高血压)的子样本参加了一项单盲2相交叉研究,其中在臂内动脉内输注选择性nNOS抑制剂S-甲基-1-硫代瓜氨酸(SMTC, 0.05、0.1和0.2μmol/ min)。在另一个对精神压力的血流反应受损的子样本(n = 21)中,在存在和不存在α-肾上腺素能拮抗剂酚妥拉明的情况下测量反应。与血压正常的受试者相比,高血压受试者的血流对精神压力的反应受到了损害(与基线相比增加了37±7%对70±8%; P <0.001)。在正常血压人群中,SMTC对精神压力的反应减弱,而在高血压人群中则不然(两组之间分别降低40±11%和3.0±14%,P = 0.01)。西地那非将血压正常受试者的血流反应对应激的反应从89±14%降低至43±14%(P <0.03),但对高血压受试者没有显着影响。酚妥拉明使对精神压力的血流受损反应增强,从39±8%增至67±13%(P <0.02)。原发性高血压与精神压力诱导的nNOS介导的血管舒张反应受损有关。这可能与高血压的交感神经流量增加有关。 nNOS功能障碍可能会损害原发性高血压中的血管稳态,并导致压力诱发的心血管事件。