钟羽琦, 王於尘, 苗芸. 多巴胺在肾移植术中临床应用价值的再认识[J]. 器官移植, 2024, 15(4): 643-647. DOI: 10.3969/j.issn.1674-7445.2024030
引用本文: 钟羽琦, 王於尘, 苗芸. 多巴胺在肾移植术中临床应用价值的再认识[J]. 器官移植, 2024, 15(4): 643-647. DOI: 10.3969/j.issn.1674-7445.2024030
Zhong Yuqi, Wang Yuchen, Miao Yun. Re-understanding of the clinical application value of dopamine in kidney transplantation[J]. ORGAN TRANSPLANTATION, 2024, 15(4): 643-647. DOI: 10.3969/j.issn.1674-7445.2024030
Citation: Zhong Yuqi, Wang Yuchen, Miao Yun. Re-understanding of the clinical application value of dopamine in kidney transplantation[J]. ORGAN TRANSPLANTATION, 2024, 15(4): 643-647. DOI: 10.3969/j.issn.1674-7445.2024030

多巴胺在肾移植术中临床应用价值的再认识

Re-understanding of the clinical application value of dopamine in kidney transplantation

  • 摘要: 多巴胺是去甲肾上腺素生物合成的前体,小剂量多巴胺主要兴奋多巴胺受体,可扩张肾及肠系膜血管,增加肾血流量,改善微循环。近年来,小剂量多巴胺以其血管活性作用广泛应用于肾移植领域。然而,随着循证医学的发展,多巴胺在肾移植术中保护移植肾灌注功能的作用开始受到人们的质疑。多项研究发现多巴胺在肾移植术中对肾功能、心功能无明显益处,升压效能较低,甚至会增加围手术期并发症的发生风险,而去甲肾上腺素可成为一种较安全的替代。因此,本文就多巴胺在肾移植术中对肾功能、心功能以及血流动力学影响的新进展进行综述,以期为多巴胺在肾移植术中的临床应用提供参考。

     

    Abstract: Dopamine is the precursor of biosynthesis of norepinephrine. Low-dose dopamine mainly excites dopamine receptors, which may dilate renal and mesenteric vessels, increase renal blood flow and improve the microcirculation. In recent years, low-dose dopamine has been widely applied in the field of kidney transplantation due to its vasoactive effect. However, with the development of evidence-based medicine, the role of dopamine in protecting the perfusion function of renal allograft in kidney transplantation has been questioned. Multiple studies have shown that dopamine brings no significant benefit to renal and cardiac function in kidney transplantation, exerts low pressor effect, and may even increase the risk of perioperative complications. Norepinephrine may be used as a safe substitute. In this article, recent progress in the effect of dopamine upon renal and cardiac function and hemodynamics during kidney transplantation was reviewed, aiming to provide reference for clinical application of dopamine in kidney transplantation.

     

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