Sekino Y, Kikuchi S, Tabayashi K, Itoh T, Suzuki Y, Mohri H
Rinsho Kyobu Geka. 1989 Dec;9(6):589-93.
Denopamine is a new, orally active, positive inotropic agent. We evaluated its clinical effects in 13 patients who had undergone cardiac operations, 8 were in early postoperative periods and 5 were in late postoperative periods. In the former, denopamine therapy (30 mg/day) were started on the 6-14 th postoperative day in 5 patients so that they might free from catecholamine drip infusion (2-14 micrograms/kg/min), and on the 14-24th postoperative day in 3 patients in order that pleural effusion might reduce. All 5 patients were weaned from catecholamine, and pleural effusion in 3 patients disappeared completely. In the latter, denopamine therapy were indicated so that they might get relief from the symptoms of chronic heart failure. Although they had undergone combined valvular operations, they still remained in NYHA class II or III postoperatively, associated with cardiomegaly, hepatomegaly and atrial fibrillation. Denopamine therapy (15-30 mg/day) were quite effective in improving subjective symptoms but not in reducing cardiomegaly or hepatomegaly. No clinically significant side effects were noticed during 9-14 months of denopamine therapy. We conclude that denopamine is a quite useful cardiotonic agent in the postoperative management of patients with cardiac surgery.
多巴胺是一种新型的、口服有效的正性肌力药物。我们评估了其对13例心脏手术后患者的临床疗效,其中8例处于术后早期,5例处于术后晚期。在前者中,5例患者在术后第6 - 14天开始使用多巴胺治疗(30毫克/天),以便他们能够停止儿茶酚胺滴注(2 - 14微克/千克/分钟),3例患者在术后第14 - 24天开始使用,以使胸腔积液减少。所有5例患者均成功停用儿茶酚胺,3例患者的胸腔积液完全消失。在后者中,给予多巴胺治疗是为了缓解慢性心力衰竭的症状。尽管他们接受了联合瓣膜手术,但术后仍处于纽约心脏协会(NYHA)心功能II级或III级,伴有心脏扩大、肝脏肿大和心房颤动。多巴胺治疗(15 - 30毫克/天)在改善主观症状方面相当有效,但在减轻心脏扩大或肝脏肿大方面效果不佳。在9 - 14个月的多巴胺治疗期间,未发现有临床意义的副作用。我们得出结论,多巴胺在心脏手术患者的术后管理中是一种非常有用的强心剂。