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静脉输注选择性DA1激动剂非诺多泮单独或与多巴胺及多巴酚丁胺联合使用时对心血管和肾脏血流动力学的影响。

Cardiovascular and renal hemodynamic effects of intravenous infusions of the selective DA1 agonist, fenoldopam, used alone or in combination with dopamine and dobutamine.

作者信息

Lass N A, Glock D, Goldberg L I

机构信息

Department of Pharmacological and Physiological Sciences, University of Chicago, Illinois 60637.

出版信息

Circulation. 1988 Nov;78(5 Pt 1):1310-5. doi: 10.1161/01.cir.78.5.1310.

Abstract

Fenoldopam (0.1 and 0.2 microgram/kg/min i.v.) was administered to pentobarbital-anesthetized dogs alone and combined with dopamine (DA) and dobutamine. Renal blood flow, heart rate, and mean arterial pressure were measured. Both dosages of fenoldopam increased renal blood flow without altering blood pressure, similar to the effects of DA (1 and 2 micrograms/kg/min). Administration of fenoldopam with only DA (1 microgram/kg/min) produced further increase in renal blood flow. After administration of phenoxybenzamine (15 mg/kg i.v.), DA produced significant increments in renal blood flow and reductions in renal vascular resistance when compared with experiments without phenoxybenzamine, suggesting even low dosages of DA exert alpha-adrenoceptor agonist activity. Dobutamine (2 and 4 micrograms/kg/min) increased renal blood flow about 37% of that produced by DA. Fenoldopam added to dobutamine produced similar increments in renal blood flow as DA. Fenoldopam did not affect the increase in cardiac contractile force produced by DA and dobutamine. Thus, fenoldopam alone or in combination with DA had no advantage over 2 and 4 micrograms/kg/min DA to further increase renal blood flow. In contrast, fenoldopam with dobutamine produced greater increments in cardiac contractile force than DA and equivalent increases in renal blood flow as DA.

摘要

将非诺多泮(静脉注射,剂量为0.1和0.2微克/千克/分钟)单独给予戊巴比妥麻醉的犬,并与多巴胺(DA)和多巴酚丁胺联合使用。测量肾血流量、心率和平均动脉压。非诺多泮的两种剂量均增加了肾血流量,而未改变血压,这与多巴胺(1和2微克/千克/分钟)的作用相似。仅将非诺多泮与多巴胺(1微克/千克/分钟)联合使用可使肾血流量进一步增加。静脉注射酚苄明(15毫克/千克)后,与未使用酚苄明的实验相比,多巴胺可使肾血流量显著增加,肾血管阻力降低,这表明即使是低剂量的多巴胺也具有α-肾上腺素能受体激动剂活性。多巴酚丁胺(2和4微克/千克/分钟)使肾血流量增加约为多巴胺所产生增加量的37%。在多巴酚丁胺中加入非诺多泮可使肾血流量产生与多巴胺相似的增加量。非诺多泮不影响多巴胺和多巴酚丁胺所产生的心脏收缩力增加。因此,单独使用非诺多泮或与多巴胺联合使用在进一步增加肾血流量方面并不比2和4微克/千克/分钟的多巴胺更具优势。相比之下,非诺多泮与多巴酚丁胺联合使用比多巴胺产生更大的心脏收缩力增加,且肾血流量增加量与多巴胺相当。

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