Lieverse A G, Girbes A R, Van Veldhuisen D J, Smit A J, Zijlstra J G, Meijer S, Lie K I, Reitsma W D
Department of Internal Medicine, University Hospital Groningen, Netherlands.
Eur Heart J. 1995 Jul;16(7):937-42. doi: 10.1093/oxfordjournals.eurheartj.a061028.
In acute studies ibopamine, an a selective dopamine agonist, induces moderate increases of GFR and ERPF, and a fall in plasma norepinephrine levels in patients with congestive heart failure (CHF). We evaluated acute and chronic effects of ibopamine on renal haemodynamics, sodium excretion, PRA, plasma aldosterone (ALD) and norepinephrine levels in an open controlled study in 10 patients aged (51-79 years) with mild CHF, NYHA class II-III. All patients used digoxin and frusemide. After a control study day, the second study day involved the administration of 100 mg ibopamine. Subsequently the patients continued to take ibopamine 100 mg three times daily for one month, at which time the chronic effects were measured on the third study day.
On the second day ERPF rose from a baseline of 288 +/- 32 to a mean of 308 +/- 32 ml.min-1 x 1.73 m-2 (P < 0.05) during the 4 h after the first administration of ibopamine and GFR rose from 77 +/- 8 to a mean of 84 +/- 8 ml.min-1 x 1.73 m-2 (P < 0.05). The ratio GFR/ERPF, representing the filtration fraction (FF) remained unchanged. On the third study day GFR and ERPF at baseline were similar to those before ibopamine treatment. After the acute on chronic administration we observed an increase in GFR (from 76 +/- 6 to a mean of 85 +/- 7 ml.min-1 x 1.73 m-2 (P < 0.05)), and in ERPF (from 279 +/- 27 to a mean of 293 +/- 29 ml.min-1 x 1.73 m-2 (P < 0.05)). Plasma norepinephrine levels fell from 2.63 +/- 0.48 to 1.92 +/- 0.27 nmol.l-1 (P < 0.05) after the acute administration of ibopamine, and remained unchanged after the acute on chronic ibopamine administration (C: 1.80 +/- 0.42 nmol.l-1). No changes in sodium excretion were observed, either in blood pressure, heart rate, PRA or ALD. We conclude that renal function is preserved during chronic ibopamine treatment and the acute moderate increase of ERPF and GFR after a single dose of 100 mg of ibopamine is still present after one month of treatment with ibopamine in patients with CHF. Ibopamine lowered plasma norepinephrine levels in our patients with CHF, and these values remained unchanged after the acute on chronic administration of ibopamine.
在急性研究中，α选择性多巴胺激动剂异波帕胺可使充血性心力衰竭（CHF）患者的肾小球滤过率（GFR）和有效肾血浆流量（ERPF）适度增加，并使血浆去甲肾上腺素水平降低。我们在一项开放对照研究中，评估了异波帕胺对10例年龄在51 - 79岁、纽约心脏协会（NYHA）心功能分级为II - III级的轻度CHF患者的肾血流动力学、钠排泄、肾素活性（PRA）、血浆醛固酮（ALD）和去甲肾上腺素水平的急性和慢性影响。所有患者均使用地高辛和呋塞米。在对照研究日之后，第二个研究日给予100毫克异波帕胺。随后患者继续每日三次服用100毫克异波帕胺，持续一个月，此时在第三个研究日测量慢性影响。
在第二个研究日，首次给予异波帕胺后的4小时内，ERPF从基线值288±32升至平均308±32毫升·分钟⁻¹×1.73平方米⁻²（P < 0.05），GFR从77±8升至平均84±8毫升·分钟⁻¹×1.73平方米⁻²（P < 0.05）。代表滤过分数（FF）的GFR/ERPF比值保持不变。在第三个研究日，基线时的GFR和ERPF与异波帕胺治疗前相似。急性加慢性给药后，我们观察到GFR增加（从76±6升至平均85±7毫升·分钟⁻¹×1.73平方米⁻²（P < 0.05）），ERPF增加（从279±27升至平均293±29毫升·分钟⁻¹×1.
