血浆β-内啡肽浓度升高对稳定型心绞痛患者外周疼痛和心绞痛阈值的影响。

Effect of raised plasma beta endorphin concentrations on peripheral pain and angina thresholds in patients with stable angina.

作者信息

Jarmukli N F, Ahn J, Iranmanesh A, Russell D C

机构信息

Cardiology Section, VA Medical Center, Salem, and University of Virginia Health Sciences Center, Charlottesville, Virginia, USA.

出版信息

Heart. 1999 Aug;82(2):204-9. doi: 10.1136/hrt.82.2.204.

DOI:10.1136/hrt.82.2.204

PMID:10409537

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1729135/

Abstract

OBJECTIVE

To determine whether changes in plasma concentrations of beta endorphins alter angina threshold and peripheral pain threshold in patients with stable angina.

DESIGN

Latin square design comparison of angina thresholds by exercise treadmill test and peripheral pain thresholds using a radiant heat source in eight patients with stable angina under control conditions, after stimulation of pituitary beta endorphin release by ketoconazole, after suppression of pituitary beta endorphin release by dexamethasone, and after blockade of opioid receptors by intravenous naloxone.

RESULTS

An approximately fivefold increase in circulating concentrations of beta endorphins was found after administration of ketoconazole (mean (SEM): 13.9 (1.2) v 73.8 (6.2) pg/ml; p < 0.05), which was associated with an increase in peripheral pain threshold to a radiant heat source (time to onset of pain perception 72 (19) v 123 (40) seconds; p < 0.05), but no significant difference in angina threshold. A reduction in circulating concentrations of beta endorphins after pretreatment with dexamethasone was statistically non-significant (13.9 (1.2) v 9.0 (1.5) pg/ml; NS) and was not associated with any change in either peripheral pain or angina thresholds. No effects were seen after blockade of opioid receptors by previous administration of intravenous naloxone.

CONCLUSIONS

Increased plasma concentrations of beta endorphins alter peripheral pain threshold but not angina threshold in patients with stable angina pectoris.

摘要

目的

确定稳定型心绞痛患者血浆β内啡肽浓度的变化是否会改变心绞痛阈值和外周疼痛阈值。

设计

采用拉丁方设计，对8例稳定型心绞痛患者在对照条件下、酮康唑刺激垂体β内啡肽释放后、地塞米松抑制垂体β内啡肽释放后以及静脉注射纳洛酮阻断阿片受体后，通过运动平板试验比较心绞痛阈值，并使用辐射热源比较外周疼痛阈值。

结果

酮康唑给药后，循环中的β内啡肽浓度增加了约5倍（均值（标准误）：13.9（1.2）对73.8（6.2）pg/ml；p<0.05），这与外周对辐射热源的疼痛阈值增加相关（疼痛感知开始时间72（19）对123（40）秒；p<0.05），但心绞痛阈值无显著差异。地塞米松预处理后β内啡肽循环浓度的降低在统计学上无显著意义（13.9（1.2）对9.0（1.5）pg/ml；无显著性差异），且与外周疼痛或心绞痛阈值的任何变化均无关。静脉注射纳洛酮预先阻断阿片受体后未观察到任何影响。