Yura T, Yuasa S, Fukunaga M, Badr K F, Matsuo H
Second Department of Internal Medicine, Kagawa Medical School, Japan.
Nephron. 1995;71(2):168-75. doi: 10.1159/000188707.
To examine the utility of Doppler ultrasound in assessing renal hemodynamics, we investigated the effects of dopamine and dobutamine on renal blood flow using Doppler ultrasound technique and conventional clearance tests in 7 healthy volunteers. After visualization of arterial blood flow in the right renal hilus by two-dimensional color flow mapping, the phasic blood flow velocity in the vessel was obtained by a pulsed Doppler method. Intravenous infusion of dopamine at a low dose increased the velocity and decreased the waveform pulsatility of renal artery blood flow without causing any significant changes in blood pressure, heart rate, or cardiac index. In contrast, dobutamine infusion increased the peak systolic velocity in a dose-dependent manner, but did not increase the mean velocity or decrease the waveform pulsatility. Percent changes of renal blood flow during infusions of both agents correlated well with those of the mean velocity. Furthermore, the degrees of changes of the waveform pulsatility were consistent with those of renal vascular resistance obtained from clearance tests and blood pressure. Our results suggest that mean velocity reflects renal blood flow and the pulsatility of blood flow waveform represents renal vascular resistance. We conclude that the effects of vasoactive agents on renal blood flow and renal vascular resistance can be estimated noninvasively, directly, and repeatedly using Doppler ultrasound.
为了研究多普勒超声在评估肾血流动力学中的应用，我们在7名健康志愿者中使用多普勒超声技术和传统清除试验，研究了多巴胺和多巴酚丁胺对肾血流的影响。通过二维彩色血流图显示右肾门处的动脉血流后，采用脉冲多普勒法获取血管内的阶段性血流速度。静脉输注低剂量多巴胺可增加肾动脉血流速度并降低波形搏动性，而不会引起血压、心率或心脏指数的任何显著变化。相比之下，多巴酚丁胺输注以剂量依赖方式增加收缩期峰值速度，但未增加平均速度或降低波形搏动性。两种药物输注期间肾血流的百分比变化与平均速度的变化密切相关。此外，血流波形搏动性的变化程度与清除试验和血压得出的肾血管阻力变化程度一致。我们的结果表明，平均速度反映肾血流，血流波形搏动性代表肾血管阻力。我们得出结论，使用多普勒超声可以无创、直接且重复地评估血管活性药物对肾血流和肾血管阻力的影响。
