Аннотация
Для лечения гиперадренергической формы синдрома постуральной ортостатической тахикардии в клинической практике применяются блокатор β1,2-адренорецепторов пропранолол, β1-блокатор бисопролол и центральный агонист тормозных пресинаптических α2-адренорецепторов - метилдофа. Сведения о влиянии указанных препаратов на кровотоки в полых венах при постуральных воздействиях в литературе отсутствуют. В острых опытах на наркотизированных кроликах мы изучали изменения кровотоков в краниальной и каудальной полых венах при ортостатическом (угол наклона стола головой вверх на 25º) и антиортостатическом (угол наклона стола головой вниз на -25º) воздействиях в течение 20 с на фоне предварительного внутривенного введения пропранолола, бисопролола и метилдофы. До применения указанных препаратов в ответ на ортостаз на 4 и 20 с отмечено снижение кровотоков в краниальной и каудальной полых венах. При антиортостазе на 4 с кровоток в каудальной вене возрастал, а к 20 с снижался до исходного значения; кровоток в краниальной вене на 4 с уменьшался, а к 20 с – был больше исходного. В ответ на применение пропранолола кровоток в каудальной полой вене снижался в большей степени, чем при внутривенном введении бисопролола и метилдофы. После применения метилдофы при ортостазе к 20 с кровоток в краниальной полой вене уменьшался более выраженно, чем в каудальной, тогда как на фоне действия пропранолола и бисопролола в условиях ортостаза кровотоки в полых венах снижались примерно в равной степени. При антиортостазе к 20 с на фоне применения пропранолола кровоток в каудальной полой вене возрастал больше, чем в краниальной. В условиях применения бисопролола и метилдофы в ответ на антиортостаз кровоток в краниальной полой вене возрастал не только в большей степени, чем в каудальной, но и более выраженно по сравнению с его приростом у кроликов исходно. Следовательно, при постуральных воздействиях на фоне применения указанных препаратов проявляются различия механизмов перераспределений кровотоков в бассейнах краниальной и каудальной полых вен.
Литература
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