Ido A, Tsuji T, Shimizu T, Fukuzawa J, Fujiuchi S, Fujita Y, Ohki Y, Sasaki N, Sakai E, Onodera S
First Department of Internal Medicine, Asahikawa Medical College, Hokkaido, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1991 Dec;29(12):1553-9.
The acute hemodynamic and blood gas changes caused by denopamine (2 micrograms/kg/min, d.i.) were investigated in 13 patients with chronic respiratory failure and secondary pulmonary hypertension. Denopamine significantly reduced mean pulmonary arterial pressure from 25 +/- 7 to 23 +/- 7 mmHg (p less than 0.05), and pulmonary vascular resistance from 314 +/- 166 to 276 +/- 168 dyne/sec/cm-5 (p less than 0.05), while mean systemic arterial pressure and systemic vascular resistance showed no significant change. Pulmonary-systemic vascular resistance ratio was reduced significantly from 0.22 +/- 0.09 to 0.18 +/- 0.09 (p less than 0.05). These findings suggest that denopamine has more marked effects on the pulmonary artery than on systemic arteries. Arterial oxygen tension (PaO2) increased significantly from 59.0 +/- 8.1 to 62.5 +/- 10.5 Torr (p less than 0.01), and arterial carbon dioxide tension (PaCO2) decreased significantly from 49.1 +/- 6.8 to 44.6 +/- 7.0 Torr (p less than 0.01) by denopamine. Mixed venous oxygen tension (PvO2), which is an indicator of tissue oxygenation, increased significantly from 33.3 +/- 3.5 to 34.4 +/- 3.3 Torr (p less than 0.05). We conclude that denopamine is thought to be useful for the improvement of hemodynamics and tissue oxygenation in patients with secondary pulmonary hypertension. However, further long-term studies are necessary to establish its therapeutic efficacy.
对13例慢性呼吸衰竭合并继发性肺动脉高压患者,研究了多巴胺(2微克/千克/分钟,静脉滴注)引起的急性血流动力学和血气变化。多巴胺使平均肺动脉压从25±7显著降至23±7毫米汞柱(p<0.05),肺血管阻力从314±166显著降至276±168达因·秒/厘米⁵(p<0.05),而平均体动脉压和体循环血管阻力无显著变化。肺循环与体循环血管阻力比值从0.22±0.09显著降至0.18±0.09(p<0.05)。这些结果表明,多巴胺对肺动脉的作用比对体动脉更显著。多巴胺使动脉血氧分压(PaO₂)从59.0±8.1显著升至62.5±10.5托(p<0.01),动脉血二氧化碳分压(PaCO₂)从49.1±6.8显著降至44.6±7.0托(p<0.01)。作为组织氧合指标的混合静脉血氧分压(PvO₂)从33.3±3.5显著升至34.4±3.3托(p<0.05)。我们得出结论,多巴胺被认为对改善继发性肺动脉高压患者的血流动力学和组织氧合有益。然而,需要进一步的长期研究来确定其治疗效果。