多巴酚丁胺与多巴胺治疗重度心力衰竭的比较
Comparison of dobutamine and dopamine in treatment of severe heart failure.
作者信息
Stoner J D, Bolen J L, Harrison D C
出版信息
Br Heart J. 1977 May;39(5):536-9. doi: 10.1136/hrt.39.5.536.
Abstract
The haemodynamic effects of dobutamine, a new synthetic catecholamine, were studied in 12 patients with severe congestive heart failure and compared with those of dopamine in 10 clinically similar patients. Dobutamine produced a distinct increase in cardiac index, while lowering left ventricular end-diastolic pressure and leaving mean aortic pressure unchanged. Dopamine also significantly improved cardiac index, but at the expense of a greater increase in heart rate than occurred with dobutamine. Dopamine was ineffective in lowering left ventricular end-diastolic pressure, but increased mean aortic pressure. We conclude that dobutamine is an effective, positive inotropic agent in patients with severe congestive heart failure. Because it has comparatively little effect on heart rate and aortic pressure, both major determinants of myocardial oxygen consumption, it may be of special value in patients with the low output syndrome associated with coronary heart disease.
摘要
对12例严重充血性心力衰竭患者研究了新型合成儿茶酚胺多巴酚丁胺的血流动力学效应，并与10例临床情况相似的患者使用多巴胺的效应进行了比较。多巴酚丁胺使心脏指数显著增加，同时降低左心室舒张末期压力，而平均主动脉压不变。多巴胺也显著改善了心脏指数，但代价是心率比使用多巴酚丁胺时增加得更多。多巴胺在降低左心室舒张末期压力方面无效，但增加了平均主动脉压。我们得出结论，多巴酚丁胺对严重充血性心力衰竭患者是一种有效的正性肌力药物。由于它对心率和主动脉压（心肌氧耗的两个主要决定因素）影响相对较小，它在与冠心病相关的低输出量综合征患者中可能具有特殊价值。
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