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二氮嗪对高血压患者血压、肾素活性和血浆醛固酮的影响(作者译)

[Effect of diazoxide on blood pressure, PRA and plasma aldosterone in hypertensive patients (author's transl)].

作者信息

Mantero F, Perini A, Armanini D, Gion M, Opocher G, Boscaro M

出版信息

G Ital Cardiol. 1976;6(7):1246-53.

PMID:1010235
Abstract

Intravenous diazoxide (300 mg) was administered to 29 hypertensive patients previously classified in subgroups according to their plasma renin and urinary aldosterone levels. The blood pressure was measured before and periodically after injection and plasma renin activity (PRA) and plasma aldosterone before and after 2 hours. The mean systolic and diastolic blood pressure fell notably from 193/118 to 155 93 mmHg; whereas PRA increased from 7.51 to 13.21 ng/ml/3 hrs and plasma aldosterone did not change significantly (71.3 and 102.8 ng%). Examining the individual sub-groups, a significant decrease in blood pressure was observed in 15 patients with low, posture unresponsive PRA, both in subjects with normal urinary aldosterone and those with surgically proven primary aldosteronism. In the former only the mean PRA showed a slight but sigificant increase, while in the latter the changes for both PRA and aldosterone were not significant. In the subgroups of patients with normal renin and urinary aldosterone the arterial pressure also significantly and promptly decreased. However, in this group the mean PRA substantially increased whereas the plasma aldosterone levels remained constant. The same blood pressure decline was observed in those patients with high PRA and aldosterone, including 1 case of pheocromocytoma. The mean PRA showed a further modest increase while the plasma aldosterone did not change significantly. These results indicate that the antihypertensive action of diazoxide is similar in the different types of hypertension (volume, vasoconstrictor or mixed form according to Laragh's classification), being independent of the basal plasma renin and aldosterone levels. Furthermore, the response of the blood pressure to diazoxide is not related in any way to the induced changes in PRA and plasma aldosterone values.

摘要

对29例高血压患者静脉注射二氮嗪(300毫克),这些患者先前已根据血浆肾素和尿醛固酮水平分为亚组。在注射前及注射后定期测量血压,并在2小时前后测量血浆肾素活性(PRA)和血浆醛固酮。平均收缩压和舒张压从193/118显著降至155/93毫米汞柱;而PRA从7.51增加至13.21纳克/毫升/3小时,血浆醛固酮无显著变化(71.3和102.8纳克%)。检查各个亚组发现,15例低肾素、体位无反应性PRA的患者血压显著下降,包括尿醛固酮正常的患者和经手术证实为原发性醛固酮增多症的患者。在前者中,仅平均PRA有轻微但显著的增加,而在后者中,PRA和醛固酮的变化均不显著。在肾素和尿醛固酮正常的患者亚组中,动脉压也显著且迅速下降。然而,在该组中,平均PRA大幅增加,而血浆醛固酮水平保持不变。在高PRA和醛固酮的患者中也观察到相同的血压下降,包括1例嗜铬细胞瘤患者。平均PRA进一步适度增加,而血浆醛固酮无显著变化。这些结果表明,二氮嗪在不同类型的高血压(根据拉腊赫分类为容量型、血管收缩型或混合型)中的降压作用相似,与基础血浆肾素和醛固酮水平无关。此外,血压对二氮嗪的反应与PRA和血浆醛固酮值的诱导变化毫无关系。

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