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近十年来,对慢性呼吸功能不全病人应用安体舒通(Spironolacton每日200～600毫克)来改善动脉血气体运输。其作用机理未明。有三种可能:①影响呼吸机制,②刺激呼吸,③作用于右心和小循环。影响呼吸机制在慢性呼吸功能不全的各种原因中,目前已倾向于不把阻塞性呼吸道疾病放在首位。六年前作者开始作安体舒通的研究时,曾认为动脉血气体运输的改善,最可能由于它对呼吸道阻塞有良好的影响。后来根据丰富的体积变更描记器测定资料确定只用安体舒通,并不能降低呼吸道的阻力。安体舒通的另一作用,可能是使肺的液体含量减少;但按作者的测量,安体舒通并不能使肺的应变性发生改变。刺激呼吸的作用安体舒通和黄体酮在化学结构上很近似而黄体酮能改变对二氧化碳敏感的呼吸调节,从而对呼吸起刺激作用。
In the past decade, spironolactone (200-600 mg daily) has been used to improve arterial blood gas transport in patients with chronic respiratory insufficiency. Its mechanism of action is unknown. There are three possibilities: ① affect the respiratory mechanism, ② stimulate the respiration, ③ role in the right heart and small circulation. Impact on Respiratory Mechanisms Of the various causes of chronic respiratory insufficiency, there is a current preference for not putting obstructive respiratory disease first. Six years ago, when the author started the study on spironolactone, it was thought that the improvement of arterial blood gas transportation was most likely due to its good effect on airway obstruction. Later, based on a wealth of volume changes in the determination of tracer data only spironolactone, and can not reduce the resistance of the respiratory tract. Another role of spironolactone may be to reduce the fluid content of the lungs; but according to the authors’ measurement, spironolactone does not alter the strain of the lungs. The role of respiratory stimulation Spironolactone and progesterone in the chemical structure is very similar to the progesterone can change the carbon dioxide-sensitive respiratory regulation, thereby stimulating the respiratory.