Ward S L, Schuetz S, Wachsman L, Bean X D, Bautista D, Buckley S, Sehgal S, Warburton D
Division of Neonatology and Pediatric Pulmonology, Childrens Hospital of Los Angeles, CA 90027.
Am J Dis Child. 1991 Jan;145(1):44-8.
Infants of substance-abusing mothers (ISAM) have significant growth and neurodevelopmental abnormalities. The origin of these abnormalities is unknown. We postulated that ISAM have increased sympathetic nervous system tone and altered catecholamine levels. Therefore, we measured plasma norepinephrine, epinephrine, and dopamine levels and the number and receptor affinity of beta-adrenoreceptor binding sites on lymphocytes and alpha-adrenoreceptor binding sites on thrombocytes in 22 otherwise healthy ISAM (age, 2.1 +/- 0.5 months; mean +/- SD) and 15 healthy controls (age, 2.5 +/- 0.8 months). Norepinephrine levels in venous blood were 1.8-fold higher in ISAM than in control infants (6.30 +/- 3.85 nmol/L vs 3.55 +/- 2.45 nmol/L). There were no differences in plasma epinephrine or dopamine levels. There were no differences in the number of binding sites or receptor affinity for beta- and alpha-adrenoreceptors. We conclude that ISAM have elevated circulating norepinephrine levels compared with controls. We speculate that this is associated with increased sympathetic nervous system tone in ISAM and that the absence of adrenoreceptor down-regulation may create catecholamine suprasensitivity.
药物滥用母亲的婴儿（ISAM）存在显著的生长和神经发育异常。这些异常的起源尚不清楚。我们推测ISAM的交感神经系统张力增加且儿茶酚胺水平改变。因此，我们测量了22名其他方面健康的ISAM（年龄，2.1±0.5个月；均值±标准差）和15名健康对照婴儿（年龄，2.5±0.8个月）的血浆去甲肾上腺素、肾上腺素和多巴胺水平，以及淋巴细胞上β-肾上腺素能受体结合位点和血小板上α-肾上腺素能受体结合位点的数量和受体亲和力。ISAM静脉血中的去甲肾上腺素水平比对照婴儿高1.8倍（6.30±3.85 nmol/L对3.55±2.45 nmol/L）。血浆肾上腺素或多巴胺水平无差异。β-和α-肾上腺素能受体的结合位点数量或受体亲和力无差异。我们得出结论，与对照相比，ISAM的循环去甲肾上腺素水平升高。我们推测这与ISAM交感神经系统张力增加有关，且肾上腺素能受体下调的缺失可能导致儿茶酚胺超敏反应。
