Objective To investigate the effects of dopamine and norepinephrine on the renal function in the patients with septic shock. Methods Eighty-seven patients with septic shock were divided into three groups （group A,B, ...Objective To investigate the effects of dopamine and norepinephrine on the renal function in the patients with septic shock. Methods Eighty-seven patients with septic shock were divided into three groups （group A,B, C） according to the biggest infusing rate of norepinephrine, with the infusing rate of 0. 5 -0. 9, 1.0 1.5,1.6-2.0 μg·kg^-1·min^-1, respectively. Mean arterial blood pressure （MAP）, heart rate （HR）, urine output, blood urea nitrogen （BUN）, creatinine （ CRE ）, urine albumin （UALB） and urine β2-microglubulin （Uβ2-MG） as well as APACHE m score in all the patients were detected. Results Before anti-shock therapy was given,hypotension, tachycardia and oliguria occurred in all the 87 patients,and CRE,BUN, U-ALB, Uβ2-MG and APACHE Ⅲ score were abnormal in most eases. With the anti-shock therapy, MAP, FIR, urine output and BUN, CRE in all patients returned to normal levels gradually, and U-ALB, Uβ2-MG levels and APACHE Ⅲ score also restored but still remained abnormal. Conclusion The first aim of treating septic shock should be restoring the organ blood supply, and based on volume resuscitation, dopamine, noradrenaline and other vasoactive drugs could be combined to maintain circulatory stability. 15 refs,2 tabs.展开更多
Objective To examine the effects of exogenously administered intermedin （IMD,adrenomedullin-2） on arterial blood pressure,cardiac function and the cardiovascular IMD receptor system in spontaneously hypertensive ra...Objective To examine the effects of exogenously administered intermedin （IMD,adrenomedullin-2） on arterial blood pressure,cardiac function and the cardiovascular IMD receptor system in spontaneously hypertensive rats （SHRs） as well as to investigate the associated mechanisms.Methods Thirteen week-old male rats were divided in Wistar Kyoto （WKY） group （n =12）,SHR group （n =12）,IMD group （SHRs infused with IMD 1-47 500 ng/kg per hour,n =12）,and ADM group （SHRs infused with adrenomedullin 500 ng/kg per hour,n =12）.Results A two-week continuous administration of low dose IMD 1-47 via mini-osmotic pumps markedly reduced blood pressure,the maximal rates of increase and decrease of left-ventricle pressure development （LV ± dp/dtmax）,left ventricular systolic pressure and heart rate in SHRs.Furthermore,IMD also inhibited protein over-expression of cardiovascular IMD receptors,myocardial Receptor Activity-Modifying Proteins （RAMP1 and RAMP2）,aortic RAMP1,RAMP2,RAMP3,and calcitonin receptor-like receptor （CRLR）;suppressed up-regulation of aortic RAMP1,RAMP2,RAMP3 and CRLR gene expression; and markedly elevated the mRNA abundance of myocardial atrial natriuretic peptide （ANP） and myocardial brain natriuretic peptide （BNP）.Additionally,IMD 1-47 administration in SHRs increased aortic cAMP concentration and reduced myocardial cAMP concentration.Conclusion These findings support the speculation that IMD,as a cardiovascular active peptide,is involved in blood pressure reduction and cardiac function amelioration during hypertension.The mechanism underlying this effect may involve IMD binding of a receptor complex formed by RAMPs and CRLR,and consequential regulation of cAMP levels and other cardiovascular active factors,such as ANP and BNP.展开更多
文摘Objective To investigate the effects of dopamine and norepinephrine on the renal function in the patients with septic shock. Methods Eighty-seven patients with septic shock were divided into three groups （group A,B, C） according to the biggest infusing rate of norepinephrine, with the infusing rate of 0. 5 -0. 9, 1.0 1.5,1.6-2.0 μg·kg^-1·min^-1, respectively. Mean arterial blood pressure （MAP）, heart rate （HR）, urine output, blood urea nitrogen （BUN）, creatinine （ CRE ）, urine albumin （UALB） and urine β2-microglubulin （Uβ2-MG） as well as APACHE m score in all the patients were detected. Results Before anti-shock therapy was given,hypotension, tachycardia and oliguria occurred in all the 87 patients,and CRE,BUN, U-ALB, Uβ2-MG and APACHE Ⅲ score were abnormal in most eases. With the anti-shock therapy, MAP, FIR, urine output and BUN, CRE in all patients returned to normal levels gradually, and U-ALB, Uβ2-MG levels and APACHE Ⅲ score also restored but still remained abnormal. Conclusion The first aim of treating septic shock should be restoring the organ blood supply, and based on volume resuscitation, dopamine, noradrenaline and other vasoactive drugs could be combined to maintain circulatory stability. 15 refs,2 tabs.
文摘Objective To examine the effects of exogenously administered intermedin （IMD,adrenomedullin-2） on arterial blood pressure,cardiac function and the cardiovascular IMD receptor system in spontaneously hypertensive rats （SHRs） as well as to investigate the associated mechanisms.Methods Thirteen week-old male rats were divided in Wistar Kyoto （WKY） group （n =12）,SHR group （n =12）,IMD group （SHRs infused with IMD 1-47 500 ng/kg per hour,n =12）,and ADM group （SHRs infused with adrenomedullin 500 ng/kg per hour,n =12）.Results A two-week continuous administration of low dose IMD 1-47 via mini-osmotic pumps markedly reduced blood pressure,the maximal rates of increase and decrease of left-ventricle pressure development （LV ± dp/dtmax）,left ventricular systolic pressure and heart rate in SHRs.Furthermore,IMD also inhibited protein over-expression of cardiovascular IMD receptors,myocardial Receptor Activity-Modifying Proteins （RAMP1 and RAMP2）,aortic RAMP1,RAMP2,RAMP3,and calcitonin receptor-like receptor （CRLR）;suppressed up-regulation of aortic RAMP1,RAMP2,RAMP3 and CRLR gene expression; and markedly elevated the mRNA abundance of myocardial atrial natriuretic peptide （ANP） and myocardial brain natriuretic peptide （BNP）.Additionally,IMD 1-47 administration in SHRs increased aortic cAMP concentration and reduced myocardial cAMP concentration.Conclusion These findings support the speculation that IMD,as a cardiovascular active peptide,is involved in blood pressure reduction and cardiac function amelioration during hypertension.The mechanism underlying this effect may involve IMD binding of a receptor complex formed by RAMPs and CRLR,and consequential regulation of cAMP levels and other cardiovascular active factors,such as ANP and BNP.
