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[洋地黄毒苷类化合物在原发性及实验性高血压中的作用]

[Compounds of the digoxin type in essential and experimental hypertension].

作者信息

Pernollet M G, Wauquier I, Grichois M L, de Mendonça M, Meyer P, Devynck M A

出版信息

Arch Mal Coeur Vaiss. 1986 Jun;79(6):882-7.

PMID:2432846
Abstract

The prescription of cardiac glycosides is usually controlled by immunological measurement of their plasma concentration. The observation of false positive digoxin measurements in patients free of this drug and the hypothesis that endogenous digitalis-like compounds might participate in body sodium and water homeostasis have led us to investigate the presence in plasma of compounds interacting with digoxin-antibodies under various physiological and pathological conditions in man and rats. The apparent levels of digoxin-equivalents in plasma of healthy control subjects (n = 21) and patients with essential hypertension (n = 48) or end-stage renal failure (n = 13) were 24.7 +/- 3.2, 34.4 +/- 4.4 and 98.7 +/- 17.4 pg/ml, p less than 0.05 and p less than 0.01 respectively. Positive correlations were observed between systolic and diastolic blood pressure and the apparent immunoreactivity of either whole or deproteinized plasma, in particular when only male subjects were considered. No relationship was found with the renal Na+ excretion or the plasma renin activity and the apparent immunoreactivity of the plasma. Its levels were however correlated with its ability to inhibit ouabain binding to the erythrocyte Na+ pump and to its capacity to reduce the renal Na+, K+-ATPase activity. In rats with experimental hypertension, induced by chronic excess salt intake either alone or associated with reduced renal mass, the cross reactivity with antidigoxin antibodies was also enhanced when compared to control rats (71.6 +/- 10.2 pg/ml, n = 12 and 57.3 +/- 5.0 pg/ml, n = 33 respectively compared to 43.4 +/- 3.7 pg/ml, n = 36, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

强心苷的处方通常通过对其血浆浓度进行免疫学测定来控制。在未服用该药物的患者中观察到地高辛测量结果呈假阳性,以及内源性洋地黄样化合物可能参与机体钠和水平衡的假说,促使我们研究在人和大鼠的各种生理和病理条件下,血浆中与地高辛抗体相互作用的化合物的存在情况。健康对照受试者(n = 21)、原发性高血压患者(n = 48)或终末期肾衰竭患者(n = 13)血浆中的地高辛当量表观水平分别为24.7±3.2、34.4±4.4和98.7±17.4 pg/ml,p值分别小于0.05和小于0.01。观察到收缩压和舒张压与全血浆或脱蛋白血浆的表观免疫反应性之间呈正相关,尤其是仅考虑男性受试者时。未发现血浆的表观免疫反应性与肾钠排泄或血浆肾素活性之间存在关联。然而,其水平与抑制哇巴因与红细胞钠泵结合的能力及其降低肾钠、钾 - ATP酶活性的能力相关。在单独通过慢性过量摄入盐或与肾质量减少相关诱导实验性高血压的大鼠中,与对照大鼠相比,与抗地高辛抗体的交叉反应性也增强(分别为71.6±10.2 pg/ml,n = 12和57.3±5.0 pg/ml,n = 33,而对照大鼠为43.4±3.7 pg/ml,n = 36,p小于0.05)。(摘要截断于250字)

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