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[人体交感神经-神经元及交感-肾上腺活动的定量参数。β受体阻滞剂的影响(作者译)]

[Quantitative parameters of sympatho-neuronal and sympatho-adrenal activities in man. The influence of beta-receptor blocking agents (author's transl)].

作者信息

Palm D, Grobecker H

出版信息

Arzneimittelforschung. 1977;27(3a):708-13.

PMID:17416
Abstract

Determination of both catecholamine concentrations (norepinephrine and epinephrine) and the activity of dopamine-beta-hydroxylase in the plasma of health volunteers and hypertensive patients leads to the conclusion that these parameters used together can be considered an index for sympathetic neuronal activity. However, highly specific and sensitive radiometric methods are necessary for the measurement of these biochemical parameters. In healthy volunteers and hypertensive patients after acute and chronic administration of beta-adrenergic blocking agents, e.g., propranolol, practolol or penbutolol, a significantly higher increase of catecholamine concentrations in the plasma has been observed during physical exercise. This pronounced increase in plasma catecholamine concentrations (mainly norepinephrine) is probably due to an enhanced compensatory sympathetic neuronal activity, accompanied by an increased peripheral resistance; this is obviously necessary in order to maintain a sufficient perfusion of peripheral tissues during work load under the influence of beta-adrenergic blocking agents, since an adequate cardiac output is prohibited by blockade of adrenergic beta-receptors. On the other hand, the pronounced increase in sympathetic tone after beta-blockade, especially after administration of high doses, could be responsible for certain reported side effects, such as hypertensive crisis in psychiatric patients or in patients with phaeochromocytoma.

摘要

对健康志愿者和高血压患者血浆中儿茶酚胺浓度(去甲肾上腺素和肾上腺素)以及多巴胺-β-羟化酶活性的测定得出结论,这些参数一起使用可被视为交感神经活动的指标。然而,测量这些生化参数需要高度特异性和灵敏的放射测定方法。在健康志愿者和高血压患者急性和慢性给予β-肾上腺素能阻滞剂(如普萘洛尔、普拉洛尔或喷布洛尔)后,在体育锻炼期间观察到血浆中儿茶酚胺浓度有明显更高的升高。血浆儿茶酚胺浓度(主要是去甲肾上腺素)的这种显著升高可能是由于代偿性交感神经活动增强,伴有外周阻力增加;在β-肾上腺素能阻滞剂的影响下,在工作负荷期间维持外周组织的充分灌注显然有必要这样做,因为肾上腺素能β受体的阻断会阻止足够的心输出量。另一方面,β受体阻断后交感神经张力的显著增加,尤其是大剂量给药后,可能是某些报告的副作用的原因,如精神病患者或嗜铬细胞瘤患者的高血压危象。

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