Lübbecke F, Wizemann V
Department of Internal Medicine, Justus-Liebig University, Giessen, Germany.
Ren Fail. 1990;12(4):257-61. doi: 10.3109/08860229009060733.
alpha 1-Adrenoceptor function and plasma catecholamine levels were investigated in chronically hemodialyzed patients with and without hemodialysis-induced hypotension. In the interdialytic period blood pressure responses as well as the mydriasis after topical application of the alpha 1-selective agonist phenylephrine were not significantly different in patients with or without hypotension during dialysis, although patients with hypotension were more susceptible to miosis induced by the muscarinergic agonist carbachol. In the normotensive group the blood pressure increasing effect of phenylephrine was attentuated after 120 min of hemodialysis therapy. Plasma noradrenaline levels were not significantly different in both groups and did not change significantly during hemodialysis, while plasma dopamine was significantly increased in the hypotensives. Thus, evidence for a pathophysiological role of a postsynaptic alpha-adrenoceptor dysfunction in hemodialysis-induced hypotension was lacking.
在有和没有血液透析引起的低血压的长期血液透析患者中，研究了α1 -肾上腺素能受体功能和血浆儿茶酚胺水平。在透析间期，透析期间有或无低血压的患者，局部应用α1选择性激动剂去氧肾上腺素后的血压反应以及散瞳情况无显著差异，尽管低血压患者对毒蕈碱能激动剂卡巴胆碱诱导的缩瞳更敏感。在血压正常组中，血液透析治疗120分钟后，去氧肾上腺素的升压作用减弱。两组的血浆去甲肾上腺素水平无显著差异，且在血液透析期间无显著变化，而低血压患者的血浆多巴胺显著升高。因此，缺乏证据表明突触后α -肾上腺素能受体功能障碍在血液透析引起的低血压中起病理生理作用。
