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静注儿茶酚胺有很强的正性肌力作用,常用于并用洋地黄、利尿剂和扩血管药仍得不到改善的重症心力衰竭者。而笔者认为,静注儿茶酚胺对重症心衰疗效并不那么高,有的即使当时挽救了生命,但停药却极其困难,其原因在于重症心衰时β受体功能降低,并导致对儿茶酚胺的反应下降。因此,了解心衰时β受体功能是阐明原因及选择、开发新疗法所必须的。本文根据①不同程度心衰患者的淋巴细胞β受体功能;②不同程度心衰患者对通过β受体产生效应的多巴酚丁胺(DOB);和不通过β受体而直接通过细胞膜,基本上与细胞内环磷酸腺苷(cAMP)浓度升高有同等作用的双丁酰环磷腺苷(DBcAMP)的反应性,来推测充血性心衰时β受体功能。对象和方法以临床上存在呼吸困难、心脏扩大、肺部罗音、颈静脉压升高和肺循环高压,诊断为充血性心衰(NY
Intravenous catecholamines have a strong positive inotropic effect, commonly used in combination with digitalis, diuretics and vasodilators are still not improved in patients with severe heart failure. The author believes that intravenous catecholamines for severe heart failure curative effect is not so high, and some even saved the lives at that time, but the withdrawal is extremely difficult because of β -receptor function decreased in severe heart failure and lead to catecholamines Reaction decreased. Therefore, to understand the β receptor function in heart failure is to clarify the causes and options, the development of new therapies necessary. This article according to ① different degrees of heart failure in patients with lymphocyte β receptor function; ② varying degrees of heart failure in patients with β-receptor effect of dobutamine (DOB); and not through the β receptor and directly through the cell membrane, The reactivity of DBcAMP, which is essentially equivalent to an increase in intracellular cyclic AMP (cAMP), is used to predict beta receptor function in congestive heart failure. Subjects and Methods Patients with clinically dyspnoea, enlarged heart, pulmonary rales, elevated jugular venous pressure and pulmonary hypertension were diagnosed as congestive heart failure (NY