Tulassay T, Seri I
Acta Paediatr Scand. 1986 May;75(3):420-4. doi: 10.1111/j.1651-2227.1986.tb10224.x.
Ten premature infants with hyaline membrane disease and with acute oliguria were treated with furosemide or furosemide and dopamine. Furosemide alone did not increase diuresis. Furosemide when combined with dopamine, however, caused significant increases in urine output, sodium excretion, fractional sodium excretion and creatinine clearance. These data suggest that the increase in the sodium excretion was due not only to a reduction in the tubular sodium reabsorption but also to an increase in the glomerular filtration rate. Since in premature neonates the creatinine clearance is not a very precise index of the glomerular filtration rate, the extent of contribution of the increase in the glomerular filtration rate to the enhanced sodium excretion cannot be determined. Despite the increase in the sodium excretion, the serum sodium concentration did not fall significantly. We conclude that the combined treatment with dopamine and furosemide is useful for treating furosemide-resistant, severe functional renal failure in preterm infants with hyaline membrane disease.
对10名患有透明膜病且急性少尿的早产儿使用呋塞米或呋塞米与多巴胺联合治疗。单独使用呋塞米并未增加尿量。然而，呋塞米与多巴胺联合使用时，尿量、钠排泄量、钠排泄分数和肌酐清除率均显著增加。这些数据表明，钠排泄增加不仅是由于肾小管钠重吸收减少，还由于肾小球滤过率增加。由于在早产儿中肌酐清除率并非肾小球滤过率的非常精确的指标，因此无法确定肾小球滤过率增加对钠排泄增加的贡献程度。尽管钠排泄增加，但血清钠浓度并未显著下降。我们得出结论，多巴胺和呋塞米联合治疗对于治疗患有透明膜病的早产儿中对呋塞米耐药的严重功能性肾衰竭是有用的。
