Poliak M, Horký K, Kopecká J, Gregorová I, Dvoráková J
III. interní katedra fakulty vseobecného lĕkarstvi Univerzity Karlovy, Praha.
Cas Lek Cesk. 1990 Mar 9;129(10):301-5.
Clonidine, an agonist of central alpha-2-adrenergic receptors, reduced the peripheral sympathetic activity. With regard to the mutual pathophysiological relationship of blood pressure regulating mechanisms, the authors wanted to find out whether after clonidine administration, in addition to the known suppression of catecholamine levels (CA), also changes in the concentration of other pressor and depressor humoral substances will occur. They investigated therefore in 15 patients with essential hypertension (EH) and in three patients with pheochromocytoma the urinary excretion of free noradrenaline (NA), adrenaline (A) and dopamine (DA), the plasma renin activity (PRA), the aldosterone concentration (PAC) and atrial natriuretic factor (ANF) in plasma, using radioimmunoanalysis, always before and 24 hours after clonidine administration (Haemiton retardR) by the oral route. Its administration led in patients with EH to a decline of NA and DA. On the other hand, in pheochromocytoma their urinary excretion did not change in an unequivocal way, and when it declined, never normal NA and DA levels were reached. A excretion remained unaltered in both groups of patients. The drop of PRA after clonidine as a result of the drop of peripheral adrenergic activity was not associated with an expected parallel drop of PAC but by its rise. This effect can be explained by a reduction of the tonic inhibition of PAC output when the DA level declines. The rise of ANF after clonidine administration will be the subject of subsequent investigations. It cannot be ruled out that this effect is due to the direct action of clonidine on alpha receptors in the heart.(ABSTRACT TRUNCATED AT 250 WORDS)
可乐定是中枢α₂ - 肾上腺素能受体激动剂,可降低外周交感神经活性。关于血压调节机制的相互病理生理关系,作者想弄清楚在给予可乐定后,除了已知的儿茶酚胺水平(CA)受到抑制外,其他升压和降压体液物质的浓度是否也会发生变化。因此,他们对15例原发性高血压(EH)患者和3例嗜铬细胞瘤患者进行了研究,采用放射免疫分析法,在口服可乐定(缓释海米通R)前及给药后24小时,检测其尿中游离去甲肾上腺素(NA)、肾上腺素(A)和多巴胺(DA)的排泄量、血浆肾素活性(PRA)、醛固酮浓度(PAC)以及血浆心房利钠因子(ANF)。在EH患者中,给予可乐定导致NA和DA排泄量下降。另一方面,在嗜铬细胞瘤患者中,其尿排泄量并没有明确的变化,即便有所下降,也从未达到正常的NA和DA水平。两组患者的A排泄量均未改变。可乐定使外周肾上腺素能活性下降,进而导致PRA下降,但这并未伴随着PAC预期的平行下降,反而使其升高。当DA水平下降时,PAC输出的紧张性抑制作用减弱,这可以解释这一效应。可乐定给药后ANF升高将是后续研究的主题。不能排除这种效应是由于可乐定直接作用于心脏的α受体所致。(摘要截选至250词)