Pirpiris M, Sudhir K, Yeung S, Jennings G, Whitworth J A
Department of Nephrology, Royal Melbourne Hospital, Australia.
Hypertension. 1992 Jun;19(6 Pt 1):567-74. doi: 10.1161/01.hyp.19.6.567.
In previous studies short-term cortisol increased cold pressor responses and the rise in forearm vascular resistance accompanying intra-arterial norepinephrine without an increase in overall resting sympathetic nervous activity. The present study examined whether these alterations in pressor response are glucocorticoid or mineralocorticoid effects, or both. Normal male subjects (n = 12) received either fludrocortisone, 0.3 mg daily (n = 6), or dexamethasone, 3 mg daily (n = 6), for 7 days. Hemodynamic studies were performed before and on day 7 of treatment. Fludrocortisone increased body weight from 69.3 +/- 1.8 to 71.1 +/- 2 kg (p less than 0.001), cardiac output from 5.0 to 6.0 l/min (+/- 0.1, p less than 0.01), mean arterial pressure from 82 +/- 1 to 91 +/- 1 mm Hg (p less than 0.001), cold pressor responsiveness from 13.0 to 39.0 mm Hg/ml per 100 ml per minute (R units) (+/- 4.3, p less than 0.01), and forearm vascular response to intra-arterial norepinephrine (F = 59.4, p less than 0.01) and angiotensin II (F = 30.8, p less than 0.01) infusions. Total peripheral resistance fell from 22.0 to 20.1 mm Hg/l per minute (+/- 0.3, p less than 0.05). Dexamethasone did not increase cardiac output, 5.1 to 5.2 l/min (+/- 0.1), or body weight but did increase mean arterial pressure from 82 +/- 3 to 91 +/- 3 mm Hg (p less than 0.001), cold pressor responsiveness from 8.6 to 17.1 R units (+/- 2.8, p less than 0.05), and forearm vascular response to intra-arterial norepinephrine (F = 33.0, p less than 0.01) and angiotensin II (F = 54.9, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
在先前的研究中,短期皮质醇会增强冷加压反应以及伴随动脉内去甲肾上腺素注射时前臂血管阻力的升高,而总体静息交感神经活动并无增加。本研究旨在探究这些加压反应的改变是糖皮质激素效应、盐皮质激素效应,还是两者皆有。12名正常男性受试者,其中6人每日服用0.3毫克氟氢可的松,另外6人每日服用3毫克地塞米松,为期7天。在治疗前及治疗第7天进行血流动力学研究。氟氢可的松使体重从69.3±1.8千克增至71.1±2千克(p<0.001),心输出量从5.0升/分钟增至6.0升/分钟(±0.1,p<0.01),平均动脉压从82±1毫米汞柱增至91±1毫米汞柱(p<0.001),冷加压反应性从13.0增至39.0毫米汞柱/(100毫升/分钟·毫升)(R单位)(±4.3,p<0.01),以及前臂血管对动脉内去甲肾上腺素(F=59.4,p<0.01)和血管紧张素II(F=30.8,p<0.01)输注的反应。总外周阻力从22.0降至20.1毫米汞柱/(升·分钟)(±0.3,p<0.05)。地塞米松未增加心输出量(从5.1升/分钟增至5.2升/分钟,±0.1)或体重,但增加了平均动脉压,从82±3毫米汞柱增至91±3毫米汞柱(p<0.001),冷加压反应性从8.6增至17.1 R单位(±2.8,p<0.05),以及前臂血管对动脉内去甲肾上腺素(F=33.0,p<0.01)和血管紧张素II(F=54.9,p<0.01)输注的反应。(摘要截选至250字)