Fishburne J I, Meis P J, Urban R B, Greiss F C, Wheeler A S, James F M, Swain M F, Rhyne A L
Am J Obstet Gynecol. 1980 Aug 15;137(8):944-52. doi: 10.1016/s0002-9378(16)32836-8.
Dopamine, a naturally occurring catecholamine precursor of norepinephrine, has been used in the treatment of cardiogenic shock. Following intravenous administation it increases cardiac output, blood pressure, and renal blood flow. Dobutamine is a directly acting inotropic agent which increases myocardial contractility without significantly changing blood pressure. This study was devised to compare the effects of these two drugs on uterine blood flow (UBF), uterine tonus (UT), mean arterial blood pressure (MAP), and heart rate (HR). Chronically instrumented pregnant ewes near term were infused with differet concentrations of dopamine and dobutamine while HR, MAP, UT and UBF were recorded continuously. Dopamine produced a decrease in UBF and an increase in MAP and UT while the HR response was variable. Dobutamine administration resulted in a marked increase in HR and a decrease in UBF, while MAP and UT remained essentially unchanged. Uterine vascular resistance increased with both drugs during high-dosage administration, but the rise was more pronounced following dopamine infusion. Since dobutamine exhibits less alpha-adrenergic activity than dopamine this drug would seem to be preferred when an inotropic agent is required for treatment of the pregnant patient.
多巴胺是去甲肾上腺素天然存在的儿茶酚胺前体，已被用于治疗心源性休克。静脉给药后，它会增加心输出量、血压和肾血流量。多巴酚丁胺是一种直接作用的强心剂，可增加心肌收缩力而不显著改变血压。本研究旨在比较这两种药物对子宫血流量（UBF）、子宫张力（UT）、平均动脉血压（MAP）和心率（HR）的影响。对接近足月的慢性植入仪器的怀孕母羊输注不同浓度的多巴胺和多巴酚丁胺，同时连续记录HR、MAP、UT和UBF。多巴胺使UBF降低，MAP和UT升高，而HR反应则各不相同。给予多巴酚丁胺导致HR显著升高，UBF降低，而MAP和UT基本保持不变。高剂量给药时，两种药物都会使子宫血管阻力增加，但多巴胺输注后升高更为明显。由于多巴酚丁胺的α-肾上腺素能活性比多巴胺低，因此在需要用强心剂治疗孕妇时，这种药物似乎更可取。
