Chodakowska J, Wocial B, Januszewicz W, Chojnowski K, Feltynowski T, Lazecki D
Department of Hypertension and Angiology, Academy of Medicine, Warsaw, Poland.
J Cardiovasc Pharmacol. 1987;10 Suppl 12:S116-21.
To investigate the possible release of beta-endorphins (beta EN) from tumors and to investigate their possible involvement in the hypotensive mechanism of clonidine (CLO) in pheochromocytoma (PHEO), as compared with essential hypertension (EH), we studied 12 patients with PHEO, 17 patients with uncomplicated stable EH (SEH), nine patients with borderline EH (BEH), and seven healthy volunteers (N). All subjects were hospitalized and excreted normal amounts of sodium. Mean blood pressure (MAP) and plasma beta EN, norepinephrine (NE), epinephrine (E), and dopamine (DA) were measured before and 180 min after an oral dose of 0.3 mg CLO. Following CLO, a significant (p less than 0.01) decrease in MAP was present in all groups. Plasma NE and E decreased (p less than 0.02 to p less than 0.01) in N, BEH, and SEH, but not in PHEO. DA did not change in any group. Pretreatment beta EN did not differ significantly between the groups, and following CLO it did not change in N or PHEO, while it increased significantly in BEH (p less than 0.01) and in SEH (p less than 0.02). Absolute changes in MAP correlated with those of beta EN only in the SEH group. Changes in NE or E did not correlate with changes in MAP in either group. Likewise, changes in NE or E were not correlated with those of beta EN, in N or EH, but a correlation between resting plasma E and resting beta EN concentrations was demonstrated in PHEO. These results support a role of beta EN in the hypotensive action of CLO in EH, but not in N or PHEO.(ABSTRACT TRUNCATED AT 250 WORDS)
为了研究肿瘤是否可能释放β-内啡肽(β-EN),以及与原发性高血压(EH)相比,其是否可能参与可乐定(CLO)对嗜铬细胞瘤(PHEO)的降压机制,我们研究了12例PHEO患者、17例无并发症的稳定EH(SEH)患者、9例临界EH(BEH)患者和7名健康志愿者(N)。所有受试者均住院且钠排泄量正常。在口服0.3 mg CLO之前和之后180分钟测量平均血压(MAP)以及血浆β-EN、去甲肾上腺素(NE)、肾上腺素(E)和多巴胺(DA)。服用CLO后,所有组的MAP均显著降低(p<0.01)。N、BEH和SEH组的血浆NE和E降低(p<0.02至p<0.01),但PHEO组未降低。DA在任何组中均未改变。治疗前各组间β-EN无显著差异,服用CLO后,N组或PHEO组未改变,而BEH组(p<0.01)和SEH组(p<0.02)显著升高。仅在SEH组中,MAP的绝对变化与β-EN的变化相关。两组中NE或E的变化与MAP的变化均不相关。同样,N组或EH组中NE或E的变化与β-EN的变化不相关,但在PHEO组中,静息血浆E与静息β-EN浓度之间存在相关性。这些结果支持β-EN在CLO对EH的降压作用中起作用,但在N组或PHEO组中不起作用。(摘要截短于250字)