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[多巴酚丁胺、多巴胺和异丙肾上腺素对实验性休克犬血流动力学影响的比较研究(作者译)]

[Comparative studies on the hemodynamic effects of dobutamine, dopamine, and isoproterenol in dogs in experimental shock (author's transl)].

作者信息

Matsumura S, Morishige E, Uno O, Ueda M

出版信息

Nihon Yakurigaku Zasshi. 1980 Mar;76(2):131-41.

PMID:7399367
Abstract

Cardiovascular effects of dobutamine (DOB), isoproterenol (Iso), and dopamine (DA) were compared in Beagle dogs weighing 6.8 to 11.6 kg under experimental shock produced by ligation of the left coronary arteries and intravenous administration of hexamethonium-Br (10 mg/kg). Intravenous infusion of DOB (1 approximately 20 microgram/kg/min) dose-dependently improved the hemodynamic state of shock by increasing left ventricular dp/dt (LV dp/dt), cardiac output (CO), and blood pressure. These improvements were also observed with the infusion of DA (20 approximately 40 microgram/kg/min). However, the improvement with Iso (0.01 approximately 0.2 microgram/kg/min) was incomplete because of the marked fall of total peripheral resistance. Both DOB and DA increased the venous return, pressure in the inferior vanae cavae, and pressure difference between venous pressure and left ventricular end diastolic pressure. It was presumed that these effects were related to the stimulation of the alpha receptor in the venous system, in addition to the marked positive inotropic effects by DOB or DA. Iso increased significantly only the venous return. Although increases of coronary flow with DOB and DA are probably mainly due to an increase of myocardial oxygen consumption, the increase of coronary perfusion pressure also may contribute to the increase of coronary flow. As a result, myocardial oxygen balance was improved with DOB or DA. alpha stimulation in the venous system as well as beta 1 stimulation apparently contributes to improvement of the deteriorated hemodynamic state, in experimental shock, as induced in dogs.

摘要

在体重6.8至11.6千克的比格犬中,通过结扎左冠状动脉并静脉注射溴化六甲铵(10毫克/千克)制造实验性休克,比较了多巴酚丁胺(DOB)、异丙肾上腺素(Iso)和多巴胺(DA)对心血管的影响。静脉输注DOB(1至20微克/千克/分钟)可通过增加左心室dp/dt(LV dp/dt)、心输出量(CO)和血压,剂量依赖性地改善休克的血流动力学状态。输注DA(20至40微克/千克/分钟)时也观察到了这些改善。然而,由于总外周阻力显著下降,Iso(0.01至0.2微克/千克/分钟)的改善并不完全。DOB和DA均增加了静脉回流量、下腔静脉压力以及静脉压力与左心室舒张末期压力之间的压差。据推测,这些作用除了与DOB或DA显著的正性肌力作用有关外,还与静脉系统中α受体的刺激有关。Iso仅显著增加了静脉回流量。虽然DOB和DA使冠状动脉血流量增加可能主要是由于心肌耗氧量增加,但冠状动脉灌注压的升高也可能有助于冠状动脉血流量的增加。结果,DOB或DA改善了心肌氧平衡。在犬类实验性休克中,静脉系统中的α刺激以及β1刺激显然有助于改善恶化的血流动力学状态。

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