Bodmann K F, Tröster S, Clemens R, Schuster H P
Medizinische Klinik I, Städtisches Krankenhaus Hildesheim, Medizinischen Hochschule Hannover.
Clin Investig. 1993 Dec;72(1):60-4. doi: 10.1007/BF00231120.
Fenoldopam, a newly developed intravenous dopaminergic DA1 receptor agonist, was used in an open, prospective study for blood pressure control in 12 patients presenting with hypertensive crisis. At a dose of 0.2-0.5 microgram kg-1 min-1 fenoldopam decreased systolic blood pressure from 209 +/- 13 to 151 +/- 17 mmHg and diastolic blood pressure from 114 +/- 10 to 78 +/- 10 mmHg. Blood pressure was controlled in all 12 patients within 5-50 min. In none of the patients did rebound hypertension occur upon termination of the study medication, nor was any adverse event reported. Major hemodynamic changes induced by fenoldopam were a decrease in total peripheral resistance from 1853 +/- 611 to 1193 +/- 368 and in pulmonary vascular resistance from 252 +/- 170 to 180 +/- 74 dyne s-1 cm-5. In patients with high left ventricular filling pressure at study pulmonary capillary wedge pressure decreased while the stroke volume index and mixed venous oxygen saturation increased under fenoldopam. Thus, fenoldopam appears to be a rapid-acting, well-tolerated, and highly effective intravenous substance for the treatment of severe hypertension.
非诺多泮是一种新开发的静脉用多巴胺能DA1受体激动剂，在一项开放性前瞻性研究中用于控制12例高血压危象患者的血压。以0.2 - 0.5微克/千克·分钟的剂量使用非诺多泮时，收缩压从209±13降至151±17毫米汞柱，舒张压从114±10降至78±10毫米汞柱。所有12例患者的血压在5 - 50分钟内得到控制。在研究药物停用后，没有患者出现反跳性高血压，也未报告任何不良事件。非诺多泮引起的主要血流动力学变化包括总外周阻力从1853±611降至1193±368，肺血管阻力从252±170降至180±74达因·秒/厘米⁵。在研究中左心室充盈压高的患者，使用非诺多泮时肺毛细血管楔压降低，而每搏量指数和混合静脉血氧饱和度增加。因此，非诺多泮似乎是一种用于治疗重度高血压的起效迅速、耐受性良好且高效的静脉用药。
