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原发性高血压患者的前臂大动脉和小动脉对血管紧张素II的反应性低于去甲肾上腺素。

Large and small forearm arteries of essential hypertensives are less reactive to angiotensin II than to noradrenaline.

作者信息

Laurent S, Lacolley P, Billaud E, Arcaro G, Safar M

机构信息

Diagnosis Centre, Paris, France.

出版信息

J Hypertens Suppl. 1989 Dec;7(6):S76-7. doi: 10.1097/00004872-198900076-00034.

Abstract

In order to investigate the reactivity to angiotensin II (Ang II) in large and small arteries in situ, brachial artery diameter, blood flow velocity, local volumic blood flow and local vascular resistance (mean arterial pressure divided by local blood flow) were determined non-invasively, using a pulsed Doppler system. Increasing doses of Ang II (0.5, 1.0 and 2.0 ng/kg per min) were given intravenously and double-blind to nine normotensive subjects (group I) and 10 hypertensive patients (group III); placebo (glucose) was given to nine hypertensives (group II). Angiotensin II did not change the brachial artery diameter, blood flow velocity, local blood flow or local resistance. Mean arterial pressure was increased slightly but significantly (P less than 0.05) by Ang II at 2 ng/kg per min in groups I and III. In contrast, we had shown previously, following the same procedure, that subthreshold doses (for the increase in mean arterial pressure) of noradrenaline reduced branchial artery diameter, velocity and local blood flow and increased local resistance in hypertensives. These results indicate that in hypertensives the vascular reactivity of the brachial circulation (1) is lower than that of other territories in response to Ang II and (2) is lower in response to Ang II than in response to noradrenaline.

摘要

为了研究大小动脉原位对血管紧张素II(Ang II)的反应性,使用脉冲多普勒系统对肱动脉直径、血流速度、局部容积血流和局部血管阻力(平均动脉压除以局部血流)进行无创测定。对9名血压正常的受试者(I组)和10名高血压患者(III组)静脉内给予递增剂量的Ang II(0.5、1.0和2.0 ng/kg每分钟),并采用双盲法;对9名高血压患者(II组)给予安慰剂(葡萄糖)。血管紧张素II未改变肱动脉直径、血流速度、局部血流或局部阻力。在I组和III组中,每分钟2 ng/kg的Ang II使平均动脉压轻度但显著升高(P小于0.05)。相比之下,我们之前按照相同程序表明,去甲肾上腺素的阈下剂量(对于平均动脉压升高而言)可使高血压患者的肱动脉直径、速度和局部血流降低,并使局部阻力增加。这些结果表明,在高血压患者中,肱循环的血管反应性(1)对Ang II的反应低于其他区域,(2)对Ang II的反应低于对去甲肾上腺素的反应。

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