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进食、阿替洛尔及其相互作用对心血管的影响:β1-肾上腺素能调节在餐后效应的发生中并不起主要作用。

Cardiovascular effects of eating, atenolol and their interaction: beta1-adrenergic modulation does not play a predominant role in the genesis of postprandial effects.

作者信息

De Mey C, Enterling D, Meineke I

机构信息

Centre for Cardiovascular Pharmacology, Mainz-Wiesbaden, Germany.

出版信息

Br J Clin Pharmacol. 1993 Nov;36(5):427-35. doi: 10.1111/j.1365-2125.1993.tb00391.x.

Abstract
  1. Eight healthy subjects were investigated on four occasions at least 1 week apart when they either ate a standard 3100 kJ cold meal or fasted. One hour earlier, either 50 mg atenolol or placebo was administered. 2. Eating was followed by prominent changes of systolic cardiovascular function: a rise of heart rate (+7, 95% CI: 4 to 9 beats min(-1)), systolic BP (+5, CI: 1 to 8 mmHg), a drop of diastolic BP (-6, CI:-9 to -3 mmHg), shortening of the pre-ejection period PEP (-11, CI: -13 to -9 ms) and electromechanical systole QS2c (-13, CI: -17 to -8 ms), a rise of the estimated cardiac output CO (+1.3, CI: 1.0 to 1.6 1 min(-1)) and a reduction of the calculated total peripheral resistance TPR (-306, CI: -389 to -222 dyn s cm(-5)). 3. Eating was also followed by an increase of the non-renal clearance of sorbitol (as a measure of hepatic blood flow) and this change was larger than proportional to the increase of CO. The plasma renin activity rose after the meal but the venous plasma noradrenaline and adrenaline concentrations were not affected. 4. The postprandial effects peaked over the first 1-2 h after the meal but remained well detectable up to 4 h after eating. 5. The administration of 50 mg atenolol before the meal reduced the postprandial effects to the same extent as the atenolol effects in the fasting state. This lack of interaction (or mere arithmetic additivity) indicates that the efferent beta1-adrenergic tone does not play a predominant role in the modulation of postprandial cardiovascular changes.
摘要
  1. 八名健康受试者在至少间隔1周的四个不同时段接受了研究,期间他们要么进食一份标准的3100千焦冷餐,要么禁食。在进食或禁食前1小时,给予50毫克阿替洛尔或安慰剂。2. 进食后,收缩期心血管功能出现显著变化:心率上升(+7,95%置信区间:4至9次/分钟),收缩压上升(+5,置信区间:1至8毫米汞柱),舒张压下降(-6,置信区间:-9至-3毫米汞柱),射血前期PEP缩短(-11,置信区间:-13至-9毫秒)和机电收缩期QS2c缩短(-13,置信区间:-17至-8毫秒),估计心输出量CO上升(+1.3,置信区间:1.0至1.6升/分钟),计算得出的总外周阻力TPR降低(-306,置信区间:-389至-222达因·秒/厘米⁻⁵)。3. 进食后山梨醇的非肾清除率也增加(作为肝血流量的指标),且这种变化与CO的增加不成正比。餐后血浆肾素活性升高,但静脉血浆去甲肾上腺素和肾上腺素浓度未受影响。4. 餐后效应在进食后最初1 - 2小时达到峰值,但在进食后4小时仍可明显检测到。5. 进餐前给予50毫克阿替洛尔可将餐后效应降低至与禁食状态下阿替洛尔的效应相同程度。这种缺乏相互作用(或仅仅是算术相加性)表明,传出β1 - 肾上腺素能张力在餐后心血管变化的调节中不起主要作用。

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