Kageshima K, Miyano K, Tanifuji Y, Kobayashi K, Kimura J
Department of Anesthesiology, Jikei University School of Medicine, Tokyo.
Masui. 1990 May;39(5):592-9.
Effects of dopamine and dobutamine in a dose of 5, 10 or 20 micrograms.kg-1.min-1 on hepatic blood flow and hepatic metabolism were studied in normotensive and hemorrhagic hypotensive (MAP 50mmHg) pigs during 1 MAC enflurane anesthesia. PaCO2 was maintained within a physiological range (30-35mmHg) by controlled ventilation. Portal venous blood flow and hepatic arterial blood flow were measured by ultrasonic blood flowmetry. Hepatic oxygen supply and consumption were calculated from blood flows and oxygen contents. Each dose of dopamine and dobutamine did not change significantly MAP and cardiac output in both normotensive and hypotensive pigs. In the normotensive state, dopamine increased significantly total hepatic blood flow and hepatic oxygen supply, by raising portal venous blood flow, but dobutamine did not increase them. Also in the hemorrhagic hypotensive state, dopamine increased significantly total hepatic blood flow and hepatic oxygen supply by increasing both portal venous blood flow and hepatic arterial blood flow, but dobutamine did not produce similar increase. On the other hand, there was no significant change in hepatic oxygen consumption in both normotensive and hypotensive pigs by dopamine and dobutamine administration. These results suggest that dopamine is superior to dobutamine for hepatic circulation and hepatic metabolism especially in the hemorrhagic hypotensive state.
在1个最低肺泡有效浓度(MAC)安氟醚麻醉期间,研究了剂量为5、10或20微克·千克⁻¹·分钟⁻¹的多巴胺和多巴酚丁胺对正常血压和失血性低血压(平均动脉压50mmHg)猪肝脏血流及肝脏代谢的影响。通过控制通气将动脉血二氧化碳分压(PaCO₂)维持在生理范围内(30 - 35mmHg)。采用超声血流仪测量门静脉血流和肝动脉血流。根据血流和氧含量计算肝脏的氧供和氧耗。在正常血压和低血压猪中,每一种剂量的多巴胺和多巴酚丁胺对平均动脉压和心输出量均无显著改变。在正常血压状态下,多巴胺通过增加门静脉血流显著增加了肝脏总血流量和肝脏氧供,但多巴酚丁胺未增加这些指标。同样在失血性低血压状态下,多巴胺通过增加门静脉血流和肝动脉血流显著增加了肝脏总血流量和肝脏氧供,但多巴酚丁胺未产生类似的增加。另一方面,在正常血压和低血压猪中,给予多巴胺和多巴酚丁胺后肝脏氧耗均无显著变化。这些结果表明,尤其是在失血性低血压状态下,多巴胺在肝脏循环和肝脏代谢方面优于多巴酚丁胺。