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多巴胺和多巴酚丁胺对犬高氧和低氧肺血管张力的影响。

Effects of dopamine and dobutamine on hyperoxic and hypoxic pulmonary vascular tone in dogs.

作者信息

Lejeune P, Naeije R, Leeman M, Melot C, Deloof T, Delcroix M

出版信息

Am Rev Respir Dis. 1987 Jul;136(1):29-35. doi: 10.1164/ajrccm/136.1.29.

Abstract

The pulmonary vascular effects of dopamine and of dobutamine have been reported variably in the literature. We investigated the effects of dopamine and of dobutamine, at doses of 10 and 20 micrograms/kg/min, on the relationships of overall mean pulmonary arterial pressure (Ppa) to cardiac index (Cl) in 14 dogs ventilated alternatively in hyperoxic (FIO2, 0.4) and in hypoxic (FIO2, 0.1) conditions. Five-point Ppa/Cl plots were constructed by opening an arteriovenous femoral fistula or by stepwise inflations of a balloon in the inferior vena cava. These Ppa/Cl plots were rectilinear in all experimental conditions. Hypoxia was associated with an increase in Ppa over the entire range of Cl studied (2 to 5 L/min/m2). A deterioration in arterial oxygenation and an increase in O2 consumption constantly occurred after dopamine as well as after dobutamine administration. At 10 micrograms/kg/min (n = 6 dogs) neither drug affected Ppa over the entire range of Cl at both 0.4 and 0.1 FIO2. At 20 micrograms/kg/min (n = 8 dogs), dopamine and dobutamine increased Ppa at the lowest Cl (2 to 4 and 2 to 3 L/min/m2, respectively) at 0.4 FIO2, and attenuated hypoxia-induced increases in Ppa over the entire range of Cl. Two repetitions of alternated 0.4 and 0.1 FIO2 exposures had no effect on Ppa/Cl plots in 6 additional dogs given no drug. We concluded that at dosages as great as 20 micrograms/kg/min, as generally given in clinical practice, dopamine and dobutamine exerted similar effects upon the pulmonary circulation of intact dogs; either no change or an increase in hyperoxic pulmonary vascular tone and either no change or an attenuation of hypoxic pulmonary vasoconstriction.

摘要

多巴胺和多巴酚丁胺对肺血管的影响在文献中的报道不一。我们研究了在14只交替处于高氧(FIO2,0.4)和低氧(FIO2,0.1)条件下通气的犬中,剂量为10和20微克/千克/分钟的多巴胺和多巴酚丁胺对总平均肺动脉压(Ppa)与心脏指数(Cl)关系的影响。通过打开股动静脉瘘或通过逐步向下腔静脉内充气来构建五点Ppa/Cl图。在所有实验条件下,这些Ppa/Cl图均为直线型。在研究的整个Cl范围内(2至5升/分钟/平方米),低氧与Ppa升高相关。给予多巴胺以及多巴酚丁胺后,动脉氧合恶化和氧消耗增加持续发生。在10微克/千克/分钟(n = 6只犬)时,在0.4和0.1的FIO2条件下,两种药物在整个Cl范围内均未影响Ppa。在20微克/千克/分钟(n = 8只犬)时,在0.4的FIO2条件下,多巴胺和多巴酚丁胺在最低Cl时(分别为2至4和2至3升/分钟/平方米)升高了Ppa,并在整个Cl范围内减弱了低氧诱导的Ppa升高。在另外6只未给药的犬中,两次交替的0.4和0.1 FIO2暴露重复对Ppa/Cl图没有影响。我们得出结论,在临床实践中通常给予的高达20微克/千克/分钟的剂量下,多巴胺和多巴酚丁胺对完整犬的肺循环产生相似的影响;要么对高氧肺血管张力无变化或增加,要么对低氧肺血管收缩无变化或减弱。

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