多巴胺肾保护作用及其在感染性休克救治中的新发现  

New findings of dopamine in renal protection and treatment of septic shock

作　　者：李佳男[1,2] 王洪乾[1] 张铁铮[1] 

机构地区：[1]沈阳军区总医院麻醉科,110016 [2]锦州医科大学研究生院,121001

出　　处：《国际麻醉学与复苏杂志》2017年第3期259-262,285,共5页International Journal of Anesthesiology and Resuscitation

基　　金：军队后勤科研重点项目（BWS12J008）

摘　　要：背景近年来有关多巴胺肾保护作用及其在感染性休克治疗中的研究呈现出多种不确定性结果，引发诸多争议。目的综述多巴胺在肾保护作用以及感染性休克救治方面的研究进展。内容同绕近年来多巴胺在基础和临床方面的应用与研究，探讨多巴胺的有效性和安全性。虽然有大量有关多巴胺肾保护作用的研究，但结论不尽一致。总体上认为，应用多巴胺行肾功能保护并无明显益处，不优于传统利尿药。在感染性休克治疗方面，多巴胺潜在的副作用尤为明显，应审慎选用。趋向在危重患者中联合应用利尿药和小剂量多巴胺或许能够成为研究热点；愈来愈多的证据支持去甲肾上腺素作为感染性休克救治的首选药物，而非多巴胺。Background Recently, it was reported that dopamine in renal protection and treatment of septic shock showing a variety of uncertain results, caused a lot of controversy. Objective Review the effects of dopamine in renal protection and treatment of septic shock. Content According to the basic and clinical aspects on dopamine, we investigated the efficacy and safety of dopamine. Although there are a large number of reports on the renal protective effect of dopamine, the conclusions are not consistent. Generally, application of dopamine in protecting renal function has no obvious benefit and is not superior to conventional diuretics. In the treatment of septic shock, dopamine should be carefully chosen because of the obviously potential side effects. Trend In critically ill patients, studies should be focused on the combination of diuretics and small dose of dopamine. More and more evidences on septic treatment support norepinephrine as the first-choice drug but not dopamine.

关 键 词：多巴胺 肾 感染性休克 

分 类 号：R614[医药卫生—麻醉学]