小剂量多巴胺对高原老年慢性肺心病患者呼吸肌疲劳治疗作用的研究  

Effect of dopamine on respiratory muscle function in elderly patients with chronic cor pulmonale in high altitude areas

作　　者：杨生岳[1] 冯恩志[1] 沈君礼[1] 索玉梅[1] 张瑛[1] 高玲[1] 赵丽红[1] 吴雪梅[1] 

机构地区：[1]解放军第四医院,青海西宁810014

出　　处：《西北国防医学杂志》2004年第4期245-247,共3页Medical Journal of National Defending Forces in Northwest China

基　　金：全军医药卫生科研基金资助项目 ( 0 1MB0 14 )

摘　　要：目的 :观察多巴胺对高原地区老年肺心病患者呼吸肌功能的影响。方法 :4 8例老年肺心病患者随机分为观察组 (A组 )和对照组 (B组 ) ,每组 2 4例。A组用多巴胺 6 0mg加入 10 %葡萄糖溶液 15 0ml,以 5 μg·kg-1·min-1的速度静滴作为治疗。B组用等量 10 %葡萄糖溶液 ,以同样速度静滴作为对照。用药前、后测定肺功能、呼吸肌功能和心功能。结果 :用药前 ,两组一秒钟用力呼气容积占预计值百分比 (FEV1%预计值 )、动脉血氧分压 (PaO2 )、二氧化碳分压 (PaCO2 )、最大吸气压 (PImax)、最大呼气压 (PEmax)、最大跨膈压 (Pdimax)、呼吸肌力量指数 (RMS)、心脏指数 (CI )和心搏指数 (SI)差异无显著性。用药后 ,A组PI max、PEmax、Pdimax、RMS、CI、SI显著高于用药前 (P均 <0 .0 1) ,B组各项指标无显著性变化。A组用药后PImax、PEmax、Pdimax、RMS与CI呈显著正相关 (r=0 .6 74、0 .5 4 1、0 .6 6 9、0 .6 2 9,P均 <0 .0 1)。结论 :小剂量多巴胺有显著增强呼吸肌功能的作用 ,可作为高原肺心病的辅助治疗。Objective:To investigate the effects of dopamine on respiratory muscle function in elderly patients with chronic cor pulmonale in high altitude areas(HACCP).Methods:48 patients with HACCP were randomly divided into 2 groups with 24 cases in each,a dopamine group(A group),and a control group(B group).Dopamine 60 mg was infused intravenously at a rate of 5 μg·kg -1 ·min -1 in group A,and 10% glucosum 150 ml was infused intravenously at the same rate in group B.Pulmonary,respiratory muscle and cardiac function were determined before and after treatment.Results:Before treatment,forced expiratory volune in 1 secend(FEV_1) as expressed percent predicted(FEV_1%pred),FEV_1 to forced vital capacity (FEV_1/FVC),maximal inspiratory pressure(PImax),maximal expiratory pressure (PEmax),maximal transdiaphragmatic pressure(Pdimax),index of respiratory muscle strength (RMS),PaO_2,PaCO_2,cardiac index (CI),stroke index(SI)were no differences between the two groups(all P >0.05).In group A,PImax,PEmax,Pdimax,RMS,CI,SI after treatment were significantly higher than those before treatment (all P <0.01). PImax,PEmax,Pdimax,RMS were positively correlated with CI in group A ( r =0.674,0.541, 0.669,0.629,all P <0.01).Conclusion:Small dose of dopamine can increase the strength of respiratory muscle in the patient with HACCP.

关 键 词：肺疾病 阻塞性 肺心病 呼吸肌功能 多巴胺 高原 

分 类 号：R541.5[医药卫生—心血管疾病]