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[慢性高血压性脑病患者锥体外系疾病中的儿茶酚胺代谢]

[Catecholamine metabolism in extrapyramidal disorders in patients with chronic hypertensive encephalopathy].

作者信息

Barkhatova V P, Lebedeva N V, Dashdorzhiĭn O, Demina E G, Larskiĭ E G

出版信息

Zh Nevropatol Psikhiatr Im S S Korsakova. 1990;90(7):32-6.

PMID:2175086
Abstract

Total and cerebral metabolism of catecholamines (CA) was examined in patients with associated chronic hypertonic encephalopathy and extrapyramidal disorders. It was discovered for the first time that there was an increase in noradrenaline in the blood and cerebrospinal fluid together with a lowering of the content of dopamine and major metabolite thereof along the pathway of oxidative deamination of homovanillic acid. CA metabolism was shown to correlate with the patients' age, duration and gravity of extrapyramidal disorders. It is suggested that the revealed metabolic disorders of CA--neurotransmitters which are likely to underlie the development of neurological deficiency and characteristic mental disorders occur as a result of the diverse complex of biochemical alterations and are related both to the complex mechanisms of the pathogenesis of essential hypertension and ischemic injury to the brain as well as to the localization in the brain of lacunar infarctions. The complexity of the pathogenic treatment of the disease is emphasized. The main approaches to the pharmacological correction of the revealed disorders are outlined.

摘要

对伴有慢性高血压性脑病和锥体外系疾病的患者进行了儿茶酚胺(CA)的整体及脑代谢检查。首次发现血液和脑脊液中去甲肾上腺素增加,同时多巴胺及其主要代谢产物沿高香草酸氧化脱氨基途径的含量降低。CA代谢与患者年龄、锥体外系疾病的病程和严重程度相关。提示所揭示的CA代谢紊乱——作为神经递质,可能是神经功能缺损和特征性精神障碍发生的基础,是由于多种复杂的生化改变所致,既与原发性高血压发病机制的复杂机制以及脑缺血损伤有关,也与腔隙性梗死在脑内的定位有关。强调了该病致病治疗的复杂性。概述了对所揭示的紊乱进行药理纠正的主要方法。

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