Edner M, Hjemdahl P, Jogestrand T, Ljunghall S
Department of Clinical Physiology, Karolinska Hospital, Stockholm, Sweden.
J Cardiovasc Pharmacol. 1991 Feb;17(2):325-31. doi: 10.1097/00005344-199102000-00020.
Physical activity and pharmacological stimulation of beta 2-adrenoceptors by salbutamol increase skeletal muscle digoxin binding with a secondary decrease in serum digoxin, possibly due to increased Na-K-ATPase activity. The present study was undertaken to examine if adrenaline (ADR) infusion and sympathoadrenal stimulation by mental stress affect the serum concentrations of digoxin and potassium. After 10 days on 0.50 mg digoxin orally, 35 healthy volunteers were investigated following 2 h of supine rest. They were divided into four groups: intravenous saline (placebo, n = 10). ADR infusion at the rates of 0.1 nmol kg-1 min-1 (ADR-L, n = 8), 0.4 nmol kg-1 min-1 (ADR-H, n = 7), or subjected to a mental stress [a color-word conflict test (CWT), n = 10]. Arterial blood samples were taken before and during the active period (50 min) and during the following 60 min (at rest) to analyze serum digoxin and potassium and plasma ADR and noradrenaline (NA). All variables were stable during placebo infusion. ADR infusions caused significant and dose-dependent decreases in serum digoxin (p less than 0.05 during ADR-L and p less than 0.001 during ADR-H) and serum potassium (p less than 0.05 and p less than 0.001, respectively). CWT, on the other hand, did not reduce serum digoxin and caused a slight decrease in serum potassium only in the poststress period. Thus, ADR caused dose-dependent shifts of digoxin and potassium, whereas mental stress failed to do so, possibly due to a modest ADR response and small increases in sympathetic nerve activity in skeletal muscle.
体力活动以及沙丁胺醇对β2肾上腺素能受体的药理刺激会增加骨骼肌地高辛结合力，同时血清地高辛继发性降低，这可能是由于钠钾ATP酶活性增加所致。本研究旨在探讨静脉输注肾上腺素（ADR）以及精神应激引起的交感肾上腺刺激是否会影响地高辛和钾的血清浓度。35名健康志愿者口服0.50 mg地高辛10天后，在仰卧休息2小时后接受研究。他们被分为四组：静脉输注生理盐水（安慰剂组，n = 10）。以0.1 nmol·kg-1·min-1的速率输注ADR（ADR-L组，n = 8）、0.4 nmol·kg-1·min-1的速率输注ADR（ADR-H组，n = 7），或接受精神应激[颜色-文字冲突测试（CWT），n = 10]。在活动期（50分钟）之前和期间以及随后60分钟（休息时）采集动脉血样，以分析血清地高辛和钾以及血浆ADR和去甲肾上腺素（NA）。在输注安慰剂期间，所有变量均稳定。ADR输注导致血清地高辛显著且呈剂量依赖性降低（ADR-L组期间p < 0.05，ADR-H组期间p < 0.001）以及血清钾降低（分别为p < 0.05和p < 0.001）。另一方面，CWT并未降低血清地高辛，仅在应激后阶段导致血清钾略有降低。因此，ADR引起地高辛和钾的剂量依赖性变化，而精神应激则未产生这种影响，这可能是由于ADR反应适度以及骨骼肌交感神经活动轻度增加所致。
