• 作者： 王有智; 王錦銘; 房同經; 陳幸一
• 作者服務機構： 國防醫學院生理及物理學系; 中央研究院生物醫學研究所臨床醫學研究中心; 三軍總醫院及國防醫學院外科部神經外科
• 中文摘要： 本實驗使用麻醉(pentobarbital)下及迷走神經切除之大白鼠，利用腦部壓迫及靜脈注射腎上腺素(025mg/kg)以引發嚴重之血壓上升及肺出血性水腫。作者研究兩種血管擴張劑Nitroglycerin(NTG)及Nitroprusside(NPS)對於血壓變化與肺病變之劑量－作用關係。在腦部壓迫或注射腎上腺素前五分鐘開始由靜脈灌注血管擴張劑直到實驗完成為止。NTG，5　/kg/min，對於血壓上升及肺病變無顯著作用，劑量增至10　/kg/min，對於腦部壓迫及腎上腺素引發之血壓上升及肺出血性水腫有部份之阻斷作用。在20　/kg/min之劑量下，雖然升壓反應僅減少43％左右，但肺病變幾乎完全避免。NPS之作用類似，但較少劑量即可達一定效果，5　/kg/min的劑量即可減少升壓反應約20％，減輕肺病變約50％；　l0　/kg/min的劑量下，肺病變幾乎完全防止。實驗結果顯示血管擴張劑Nitroglycerin及Nitroprusside均可減弱或防止腦部壓迫及腎上腺素引發之升壓反應及肺出血性水腫，兩種藥物均可減輕心臟之前負荷及後負荷，因此其藥效可能與舒解心室負荷之作用有關，Nitroprusside與Nitroglycerin相比較，前者之藥效較強。
• 英文摘要： In vagotomized and pentobarbital-anesthetized rats, massive pulmonary hemorrhagic edema wasproduced by cerebral compression (CC) or an iv injection of epinephrine (EP) 0.25 mg/kg. The pulmonarychanges were induced following severe Cushing reaction manifested by systemic hypertension. We deter-mined the dose-effect relationship of nitroglycerin (NTG) and nitroprusside (NPS) on the changes in sys-temic arterial pressure and lung pathology. The drugs were given by iv infusion 5 min before CC or EP andcontinued throughout the experiment. NTG, 5 /kg/min, did not affect the pressor response and thepulmonary damage. In a dose of 10 /kg/min, the CC- and EP-induced changes were partially blocked. Adose of 20 /kg/min almost completely prevented the CC- and EP-induced pulmonary changes despitepartial blockade of the pressor response. NPS exerted more potent effects than NTG on such changes. Adose of 5 /kg/min was capable of decreasing the pressor response by about 20% and the lung changes byabout 50%. In a dose of 10 /kg/min, the pulmonary changes were almost completely prevented. Theresults suggest that vasodilators such as nitroglycerin and nitroprusside can block the pressor response andpulmonary pathology subsequent to CC or EP. The effects may be attributed to the ventricular unloadingaction of these vasodilators that decrease the preload and afterload of the heart. In this respect, nitroprus-side is more potent than nitroglycerin.
• 中文關鍵字： neurogenic pulmonary edema; cerebral comperession; vasodilator; epinephrine hemody-namics
• 英文關鍵字： --