心房尿钠肽与硫酸镁对妊娠高血压综合征患者的心功能效应(PDF)
《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]
- 期数:
- 2000年第6期
- 页码:
- 458-460
- 栏目:
- 论著
- 出版日期:
- 2000-12-01
文章信息/Info
- Title:
- The effect of atrial natriuretic peptide and magnesium sulphate on the cardiac function of patients with pregnancy induced hypertension
- Author(s):
- YANG Ying; YANG Meng-geng; YAO Yuan-qing; JIANG Feng
- Department of Obsetrics and Gynecology, Tangdu Hospital, Fourth Military Medical University, Xi'an Shaanxi 710038, China
- Keywords:
- atrial natriuretic peptide; magnesium sulphate; pregnancy; hypertension; ventricular function
- 分类号:
- R544.4; R972.4
- DOI:
- -
- 文献标识码:
- A
- 摘要:
- 目的 探讨心房尿钠肽 (ANP)与硫酸镁对妊娠高血压综合征 (PIH)患者的心功能效应。方法 40例 PIH患者随机分为 ANP组及硫酸镁组 ,每组各 2 0例。分别给予 ANP(6 μg/ kg)或硫酸镁 (2 5 0 g/ L,2 0 ml)静滴 30 min。应用美国 Acuson18XP/ 10型彩色电脑声像仪 ,监测用药前后的心功能变化。选正常孕妇 2 0例为基础心功能对照组。结果 与对照组比较 ,PIH组心功能参数波动范围明显增加 ,但心排出量 (CO)、心率 (HR)及总外周阻力 (TPR)均值仍明显增高 (P<0 .0 1或 P<0 .0 5 )。ANP治疗后平均动脉压 (MAP) ,HR及 TPR明显下降 (均 P<0 .0 1)。CO、心排血指数 (CI)及每搏输出量 (SV)升高或下降不一致 ,但均接近正常范围。HR,CO,CI及 SV变化值与基础参数值呈显著正相关 (P<0 .0 1或 P<0 .0 5 )。硫酸镁组 SV,CO,CI及 HR呈增高趋势 ,但差异无显著意义 (P>0 .0 5 )。MAP无明显变化 (P>0 .0 5 ) ,TPR明显下降 (P<0 .0 1)。结论 ANP纠正PIH患者的心功能紊乱, 硫酸镁可能对改善PIH 患者的心功能不起重要作用。
- Abstract:
- AIM To investigate the effect of atrial natriuretic peptide (ANP) and magnesium sulphate on the cardiac function of patients with pregnancy induced hypertension (PIH). METHODS 40 PIH patients were divided randomizely into two groups and infused intraveneusly with ANP(6 μg/kg) or magnesium sulphate (250 g/L,20 ml) for 30 min. The parameters of cardiac function were determined with Acuson 18 XP/10 computed sonography before and after infusion of either ANP or magnesium sulphate. 20 normal pregnancy women as control group. RESULTS: The ranges of cardiac parameters in PIH patients were obviously extented. However the average value of cardiac output (CO), cardiac index (CI), heart rate (HR ) and total peripheral resistance (TPR) in PIH patients were significantly elevated (P < 0. 01 o r P < 0. 05) compared with control group. After infusion of ANP mean arterial pressure (MAP) , HR and TPR were significantly decreased (P < 0. 01, respectively). The levels of CO, CI and SV increase or decrease were different, but all approached to normal range. There was a positive correlation between changes in HR, CO , CI, SV and each basic index. In magnesium sulphate group, the change of MAP was no significantly difference (P > 0. 05) and SV, CO, CI and HR tended to increase but no significantly difference (P > 0. 05, respectively) and TPR decreased (P < 0. 01). CONCLUSION AN Padju sted the imbalance of cardiac function and magnesium sulphate may play less role in improving the cadiac function of PIH patients.
参考文献/References
[1] Poulsen H, Olofsson P, Stijernquist M. Effects of head-down tilt on atrial natriuretic peptide and the renin system in pregnancy [J]. Hypertension, 1995, 25 (6) : 1161.
[2] 张利朝, 杨梦庚, 施溥涛, 等. 高活性心钠素治疗妊高征及超氧化物歧化酶的研究[J]. 中华妇产科杂志, 1992, 27 (1) : 2.
[3] Easterling TR. The maternal hemodynamics of preeclampsia [J]. Clin Obstet Gynecol, 1992, 35 (2) : 375.
[4] Hidaka A. Clinical and experimental study on the pathogenesis in pregnancy induced hypertension [J]. Nippon Sanka Fujinka Gakkai Zasshi, 1988, 40 (8) : 1010.
[5] Guyton AC. Dominant role of the kidneys and accessory role of whole-body auto regulation in the pathogenesis of hypertension [J]. Am J Hypertens, 1989, 2 (7) : 575.
[6] Ota K, Kimura T, Shoji M, et al. Interaction of ANP with endothelin on cardiovascular, renal and endocrine function [J]. Am J Physiol, 1992, 262 (2) : E135.
[7] 臧益民, 裴建明, 冯华松, 等. 利钠利尿肽的生理作用和临床意义[J]. 心功能杂志, 1998, 10 (2) : 89.
[8] 杨梦庚, 王金声, 邱学华, 等. 应用人工固相合成的人心钠素II治疗妊高征引起的心力衰竭[ J ]. 中华妇产科杂志, 1993, 28(5) : 272.
[9] 徐成斌. 心钠素对充血性心衰患者血液动力学及肾脏效应的进一步观察[J]. 北京医科大学学报, 1987, 19: 219.
[10]杨 瑛, 杨梦庚, 张晓莉, 等. 人心钠素对妊高征患者视网膜中动脉及脐动脉血液动力学效应[ J ]. 第四军医大学学报, 1999,20 (6) : 528.
备注/Memo
- 备注/Memo:
- 收稿日期：1999-11-18.
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