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心得安作为一种非心脏选择性β-肾上腺素受体阻滞剂,现已被用于预防肝硬化引起的胃肠道出血。其主要副作用之一是阻断β_2-受体而导致支气管痉挛,尤其是在有气道阻塞的病人。作者对伴有气体交换障碍的肝硬化病人应用心得安后作肺功能测定和血气分祈,以了解该药可能产生的影响。病人与方法:10名酒精性肝硬化病人,其肺泡-动脉氧压差(A-a)DO_2均大于25 mmHg。其中8例动脉血氧分压(PaO_2)低于80 mmHg,其余2例由于代偿性过度通气而P_aO_2正常。心得安以1 mg/min的速度静脉内注入直至心率减慢>25%,或最大剂量达到30 mg。于给药前后分别测定病人用力的(最大)肺活
As a non-cardiac selective beta-adrenergic blockers, propranolol has been used to prevent gastrointestinal bleeding caused by cirrhosis. One of its major side effects is the block of beta 2-receptors leading to bronchospasm, especially in patients with airway obstruction. The authors applied propranolol for pulmonary function tests and blood gas analysis to patients with cirrhosis accompanied by gas exchange disorders to understand the possible effects of the drug. PATIENTS AND METHODS: All 10 patients with alcoholic cirrhosis had alveolar-arterial oxygen pressure (A-a) DO_2 greater than 25 mmHg. Among them, 8 patients had arterial partial pressure of oxygen (PaO_2) less than 80 mmHg, and the remaining 2 patients had normal P_aO_2 due to compensatory hyperventilation. Propranolol is injected intravenously at a rate of 1 mg / min until heart rate is reduced> 25%, or maximal dose is 30 mg. Before and after administration were measured patient force (maximum) lung live