Fujise Y, Hanawa K, Takada T, Kikuchi K, Moriguchi O
Jpn Circ J. 1975 May;39(5):597-600. doi: 10.1253/jcj.39.597.
CI, TPRI, PV, ECFV, Nae, PRA and a pressor response to NA and AT was measured before and after 1) sodium restriction and 2) spontaneous blood pressure fall (spontaneous fall) in the patients with essential hypertension and the following results were obtained. 1) CI did not change during sodium restriction and increased after spontaneous fall. TPRI was reduced and the degree of this reduction was positively correlated with that of blood pressure reduction under these two conditions. 2) Sodium restriction caused the decrease of PV, ECFV and Nae and the increase of PRA. The degree of the reduction of PV and Nae was positively correlated with that of blood pressure fall. After spontaneous fall, PV, ECFV and NAe was increased and PRA did not change significantly. 3) A pressor response to NA and AT was depressed after one week of sodium restriction, and after 4 weeks the former returned to the basal response, while the latter was still reduced. NA response was correlated positively with basal Nae, ECFV and interstitielle fluid volume and negatively with basal PRA. AT response was negatively correlated with PRA before and during sodium restriction. No correlation was observed, however, between the degree of reduction of blood pressure and that of the change in pressor response to NA or AT. After spontaneous fall, the response to NA was not reduced but increased. These results suggested that, although the fall in blood pressure under these experimental conditions was mediated by the reduction of TPRI, the changes in pressor response to NA and AT did not affect primarily the reduction of blood pressure.
在原发性高血压患者中,分别在1)限钠和2)血压自发下降(自发性下降)前后测量心指数(CI)、总外周阻力指数(TPRI)、血浆容量(PV)、细胞外液容量(ECFV)、钠平衡(Nae)、肾素活性(PRA)以及对去甲肾上腺素(NA)和血管紧张素(AT)的升压反应,结果如下:1)限钠期间CI无变化,自发性下降后升高。TPRI降低,且在这两种情况下,其降低程度与血压降低程度呈正相关。2)限钠导致PV、ECFV和Nae降低,PRA升高。PV和Nae的降低程度与血压下降程度呈正相关。自发性下降后,PV、ECFV和NAe升高,PRA无明显变化。3)限钠1周后对NA和AT的升压反应减弱,4周后前者恢复至基础反应,而后者仍降低。NA反应与基础Nae、ECFV和组织间液量呈正相关,与基础PRA呈负相关。限钠前及限钠期间,AT反应与PRA呈负相关。然而,血压降低程度与对NA或AT升压反应的变化程度之间未观察到相关性。自发性下降后,对NA的反应未降低反而升高。这些结果表明,尽管在这些实验条件下血压下降是由TPRI降低介导的,但对NA和AT升压反应的变化并非主要影响血压降低。