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人体中的肾素释放、沙拉新与血管舒张剂-β受体阻滞剂的药物相互作用

Renin release, saralasin and the vasodilator-beta-blocker drug interaction in man.

作者信息

Pettinger W A, Mitchell H C

出版信息

N Engl J Med. 1975 Jun 5;292(23):1214-7. doi: 10.1056/NEJM197506052922304.

Abstract

Saralasin, an angiotensin antagonist, was used to study the role of renin-angiotensin in the vasodilator-beta-blocker drug interaction in hypertensive subjects. Plasma renin activity was elevated by withdrawal of propranolol in seven patients using minoxidil and propranolol. After propranolol withdrawal, saralasin caused hypotension (100/60 mm Hg or less) in five. Propranolol lowered blood pressure and plasma renin activity and diminished the hypotensive response to saralasin. Saralasin induced renin release in all patients, an effect blocked by propranolol. We conclude that angiotensin can be the major determinant of blood pressure in vasodilator-drug treated patients, that propranolol lowering of blood pressure in this vasodilator-beta-blocker drug interaction is related to suppression of renin release, and that the angiotensin feed-back-suppression mechanism for inhibiting renin release in functionally located proximal to beta-adrenergic receptors mediating renin release.

摘要

血管紧张素拮抗剂沙拉新被用于研究肾素-血管紧张素在高血压患者血管扩张剂与β受体阻滞剂药物相互作用中的作用。在7例使用米诺地尔和普萘洛尔的患者中,停用普萘洛尔后血浆肾素活性升高。停用普萘洛尔后,沙拉新使5例患者出现低血压(100/60 mmHg或更低)。普萘洛尔降低血压和血浆肾素活性,并减弱对沙拉新的降压反应。沙拉新在所有患者中均诱导肾素释放,这一效应被普萘洛尔阻断。我们得出结论,血管紧张素可能是血管扩张剂治疗患者血压的主要决定因素,在这种血管扩张剂与β受体阻滞剂的药物相互作用中,普萘洛尔降低血压与抑制肾素释放有关,并且抑制肾素释放的血管紧张素反馈抑制机制在功能上位于介导肾素释放的β肾上腺素能受体近端。

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