Leier C V, Heban P T, Huss P, Bush C A, Lewis R P
Circulation. 1978 Sep;58(3 Pt 1):466-75. doi: 10.1161/01.cir.58.3.466.
Thirteen patients with severe cardiac failure underwent a single crossover study of dopamine and dobutamine in order to compare the systemic and regional hemodynamic effects of the two drugs. The dose-response data demonstrated that dobutamine (2.5--10 microgram/kg/min) progressively and predictably increases cardiac output by increasing stroke volume, while simultaneously decreasing systemic and pulmonary vascular resistance and pulmonary capillary wedge pressure. There was no change in heart rate or premature ventricular contractions (PVCs)/min at this dose range. Dopamine (2--8 microgram/kg/min) increased the stroke volume and cardiac output at 4 microgram/kg/min. Dopamine at less than 4 microgram/kg/min provided little additional increase in cardiac output and increased the pulmonary wedge pressure and the number of PVCs/min. At greater than 6 microgram/kg/min, dopamine increased heart rate. During the 24-hour maintenance-dose infusion of each drug (dopamine 3.7--4, dobutamine 7.3--7.7 microgram/kg/min), only dobutamine maintained a significant increase of stroke volume, cardiac output, urine flow, urine sodium concentration, creatinine clearance and peripheral blood flow. Renal and hepatic blood flow were not signfiicantly altered by the maintenance dose of either drug. Systemic and regional hemodynamic data suggest that dobutamine has many advantages over dopamine when infused in patients with cardiac failure.
13名严重心力衰竭患者进行了多巴胺和多巴酚丁胺的单交叉研究，以比较这两种药物的全身和局部血流动力学效应。剂量反应数据表明，多巴酚丁胺（2.5 - 10微克/千克/分钟）通过增加每搏量可逐渐且可预测地增加心输出量，同时降低全身和肺血管阻力以及肺毛细血管楔压。在此剂量范围内，心率或室性早搏（PVCs）/分钟无变化。多巴胺（2 - 8微克/千克/分钟）在4微克/千克/分钟时增加每搏量和心输出量。低于4微克/千克/分钟的多巴胺对心输出量几乎没有额外增加，反而增加肺楔压和PVCs/分钟的数量。大于6微克/千克/分钟时，多巴胺增加心率。在每种药物24小时维持剂量输注期间（多巴胺3.7 - 4，多巴酚丁胺7.3 - 7.7微克/千克/分钟），只有多巴酚丁胺能使每搏量、心输出量、尿量、尿钠浓度、肌酐清除率和外周血流量显著增加。两种药物的维持剂量对肾和肝血流量均无显著影响。全身和局部血流动力学数据表明，在心力衰竭患者中输注时，多巴酚丁胺比多巴胺有许多优势。
