Zhang J, Penny D J, Kim N S, Yu V Y, Smolich J J
Centre for Heart and Chest Research Department of Medicine Monash Medical Centre 246 Clayton Road Clayton 3168 Victoria Australia.
Arch Dis Child Fetal Neonatal Ed. 1999 Sep;81(2):F99-F104. doi: 10.1136/fn.81.2.f99.
To compare changes in global haemodynamics as well as anterior cerebral and superior mesenteric artery perfusion after dopamine treatment.
Anterior cerebal and superior mesenteric artery perfusion was measured using Doppler ultrasonography in hypotensive preterm neonates in whom cardiac output increased (group 1, n=10) or decreased (group 2, n=40) after dopamine treatment.
Despite a lower dopamine infusion rate, the blood pressure increase (mm Hg) in group 2 [Delta=13(1); mean(SE)] exceeded that in group 1 [Delta=8(1)], while systemic vascular resistance (mm Hg/l/min/kg) rose in group 2 [Delta=106 (37)], but was unchanged in group 1 [Delta=9 (6)]. Anterior cerebral artery blood velocity and resistance were unaffected by dopamine. However, compared with unchanged values in group 1, superior mesenteric artery blood velocity fell by 14.7(4.8) cm/s and resistance increased by 4.1(0.7) mm Hg/cm in group 2.
These results suggest that, in a portion of hypotensive preterm neonates, the increase in blood pressure induced by dopamine is related to a predominant vasoconstrictor action and is associated with a fall in bowel perfusion.
比较多巴胺治疗后整体血流动力学以及大脑前动脉和肠系膜上动脉灌注的变化。
采用多普勒超声测量多巴胺治疗后心输出量增加的低血压早产儿（第1组，n = 10）和心输出量减少的低血压早产儿（第2组，n = 40）的大脑前动脉和肠系膜上动脉灌注。
尽管第2组多巴胺输注速率较低，但血压升高幅度（mmHg）[Δ = 13(1)；均值（标准误）]超过第1组[Δ = 8(1)]，而第2组全身血管阻力（mmHg/l/min/kg）升高[Δ = 106(37)]，第1组则无变化[Δ = 9(6)]。多巴胺对大脑前动脉血流速度和阻力无影响。然而，与第1组无变化的值相比，第2组肠系膜上动脉血流速度下降14.7(4.8)cm/s，阻力增加4.1(0.7)mmHg/cm。
这些结果表明，在一部分低血压早产儿中，多巴胺引起的血压升高与主要的血管收缩作用有关，且与肠道灌注下降有关。
