Okuno Y, Mashimo T, Takashina M, Hagihira S, Inagaki Y, Mori T, Yoshiya I
Department of Anesthesia, Osaka Prefectural General Hospital.
Masui. 1997 Jan;46(1):87-94.
Systemic hypertension is a constant feature of chronic renal failure, mediated by renin and exacerbated by salt and fluid loading. Vascular atherosclerosis appears to accelerate in patients on long-term dialysis. Therefore, it is important to control hypertension and keep appropriate renal blood flow during living renal transplantation surgery. Amrinone, a phosphodiesterase inhibitor, produces vasodilation in arterial smooth muscle as well as venodilation in the capacitance bed. By increasing myocardial contractility it increases inotropic effect. Amrinone has potent inodilator effects because of its dual mechanism of action. The current study is aimed to compare hemodynamic effects between amrinone (3-5 mg.kg-1.min-1) (AMR group, n = 4) and nitroglycerin (0.3-1.0 mg.kg-1.min-1) (NTG group, n = 5), combined with dopamine (3-5 mg.kg-1.min-1) in nine patients undergoing living renal transplantation. Increase in cardiac index in AMR group was significantly larger than that in NTG group. Values of systemic and pulmonary vascular resistance in AMR group were significantly smaller than those in NTG group. No significant difference was found in renal function in the post-operative period.
系统性高血压是慢性肾衰竭的一个持续特征,由肾素介导,并因盐和液体负荷而加重。长期透析患者的血管动脉粥样硬化似乎会加速。因此,在活体肾移植手术期间控制高血压并保持适当的肾血流量非常重要。氨力农是一种磷酸二酯酶抑制剂,可使动脉平滑肌舒张,也可使容量血管床舒张。通过增加心肌收缩力,它增强了变力作用。氨力农因其双重作用机制而具有强大的血管扩张和正性肌力作用。本研究旨在比较9例接受活体肾移植患者中,氨力农(3 - 5mg·kg-1·min-1)(AMR组,n = 4)和硝酸甘油(0.3 - 1.0mg·kg-1·min-1)(NTG组,n = 5)联合多巴胺(3 - 5mg·kg-1·min-1)的血流动力学效应。AMR组的心指数增加显著大于NTG组。AMR组的全身和肺血管阻力值显著小于NTG组。术后肾功能无显著差异。