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大剂量纳洛酮对冷加压试验引起的血浆肾上腺素反应的差异效应。

Differential effect of high-dose naloxone on the plasma adrenaline response to the cold-pressor test.

作者信息

Bouloux P M, Newbould E, Causon R, Perry L, Rees L H, Besser G M, Grossman A

机构信息

Department of Endocrinology, St Bartholomew's Hospital, London.

出版信息

Clin Sci (Lond). 1989 Jun;76(6):625-30. doi: 10.1042/cs0760625.

DOI:10.1042/cs0760625
PMID:2544345
Abstract
  1. Although the opiate antagonist naloxone has been shown to affect sympathoadrenomedullary function in some studies, this has not been a uniform finding in all investigations, using different doses of naloxone. We have therefore investigated the actions of saline placebo and increasing bolus doses of intravenous naloxone (25, 100 and 250 micrograms/kg) on the plasma noradrenaline, adrenaline, adrenocorticotrophin (ACTH) and cortisol responses to a cold-pressor test in six males and two females in a double-blind randomized study. 2. Basal levels of adrenaline did not differ on any of the study occasions: the cold-pressor stimulus produced a significant rise in mean plasma adrenaline to a peak of 0.16 nmol/l, with a peak incremental rise of 0.08 nmol/l. In the presence of the two higher doses of naloxone, the incremental rise in the mean adrenaline level was significantly enhanced, reaching 0.30 nmol/l at 100 micrograms of naloxone/kg and 0.29 nmol/l at 250 micrograms of naloxone/kg, with no significant enhancement observed at the lowest dose of naloxone. The rise in plasma noradrenaline, systolic and diastolic blood pressure and pulse rate during the cold-pressor test was not consistently altered by any dose of naloxone, but there was a significant trend for the degree of discomfort to increase with the dose of naloxone. 3. Neither plasma ACTH nor serum cortisol rose in response to the cold-pressor stimulus.(ABSTRACT TRUNCATED AT 250 WORDS)
摘要
  1. 尽管在一些研究中已表明阿片类拮抗剂纳洛酮会影响交感肾上腺髓质功能,但在所有使用不同剂量纳洛酮的研究中,这一结果并不一致。因此,在一项双盲随机研究中,我们调查了生理盐水安慰剂以及静脉注射递增剂量纳洛酮(25、100和250微克/千克)对6名男性和2名女性在冷加压试验中血浆去甲肾上腺素、肾上腺素、促肾上腺皮质激素(ACTH)和皮质醇反应的影响。2. 在任何研究阶段,肾上腺素的基础水平均无差异:冷加压刺激使平均血浆肾上腺素显著升高至峰值0.16纳摩尔/升,峰值增量升高为0.08纳摩尔/升。在使用两种较高剂量纳洛酮时,平均肾上腺素水平的增量升高显著增强,在纳洛酮100微克/千克时达到0.30纳摩尔/升,在纳洛酮250微克/千克时达到0.29纳摩尔/升,而在最低剂量纳洛酮时未观察到显著增强。在冷加压试验期间,任何剂量的纳洛酮均未持续改变血浆去甲肾上腺素、收缩压和舒张压以及脉搏率的升高,但不适程度有随纳洛酮剂量增加而增加的显著趋势。3. 血浆ACTH和血清皮质醇均未因冷加压刺激而升高。(摘要截断于250字)

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