Mero K A, Choe E U, Flint L M, Ferrara J J
Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA.
J Pediatr Surg. 1998 May;33(5):688-93. doi: 10.1016/s0022-3468(98)90188-9.
Dopexamine is a specific dopaminergic and beta2-adrenergic agonist. Using newborn piglets, we have previously shown that (1) dopexamine increases cardiac output and mesenteric blood flow; (2) indomethacin reduces mesenteric blood flow.
Ultrasonic blood flow probes were placed around the ascending aorta, cranial mesenteric artery, and a renal artery of 0 to 2-day-old and 2-week-old piglets. Animals of each age were grouped (5 to 8 animals per group) and subjected to one of three experimental protocols: (1) 0.4 mg/kg indomethacin infusion, (2) 10 microg/kg/min dopexamine infusion begun 10 minutes before indomethacin, or (3) no treatment.
Control animals demonstrated no significant alterations in mesenteric blood flow. Compared with baseline, indomethacin produced significant (P< .05, analysis of variance) declines in cranial mesenteric artery blood flow in 0 to 2-day old (37.2+/-5.7 mL/min v 17.9+/-3.7 mL/min at 90 min), and 2-week-old (80.2+/-12.5 mL/min v 29.7+/-5.7 mL/min at 90 minutes) piglets. In both animal groups treated with dopexamine before indomethacin, the decreases in cranial mesenteric artery blood flow were eliminated (38.4+/-7.6 mL/min at baseline v 36.5+/-6.8 mL/min at 90 minutes in 0 to 2 day olds; 79.9+/-10.0 mL/min at baseline v 77.5+/-14.7 mL/min in 2 week olds). Indomethacin-induced declines in renal blood flow were similarly abrogated by dopexamine.
Dopexamine may prove of clinical benefit when a neonate is considered a candidate for indomethacin therapy.
多培沙明是一种特异性多巴胺能和β2-肾上腺素能激动剂。我们之前利用新生仔猪证实:(1)多培沙明可增加心输出量和肠系膜血流量;(2)吲哚美辛可降低肠系膜血流量。
将超声血流探头置于0至2日龄和2周龄仔猪的升主动脉、肠系膜上动脉和肾动脉周围。每个年龄段的动物进行分组(每组5至8只动物),并接受以下三种实验方案之一:(1)输注0.4mg/kg吲哚美辛;(2)在输注吲哚美辛前10分钟开始输注10μg/kg/min多培沙明;(3)不进行治疗。
对照动物的肠系膜血流量无显著变化。与基线相比,吲哚美辛使0至2日龄(90分钟时37.2±5.7mL/min对17.9±3.7mL/min)和2周龄(90分钟时80.2±12.5mL/min对29.7±5.7mL/min)仔猪的肠系膜上动脉血流量显著下降(方差分析,P<0.05)。在吲哚美辛前接受多培沙明治疗的两个动物组中,肠系膜上动脉血流量的下降均被消除(0至2日龄基线时38.4±7.6mL/min对90分钟时36.5±6.8mL/min;2周龄基线时79.9±10.0mL/min对77.5±14.7mL/min)。多培沙明同样消除了吲哚美辛引起的肾血流量下降。
当考虑将新生儿作为吲哚美辛治疗的候选对象时,多培沙明可能具有临床益处。