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[轻度原发性动脉高血压中血管对加压素的高反应性]

[Vascular hyperreactivity to vasopressin in mild essential arterial hypertension].

作者信息

Cases Amenós A, Muñoz Ruiz I, Gaya Beltrán J, Botey Puig A, Rivera Fillat F, Sanz Romero G, Revert Torrellas L

出版信息

Med Clin (Barc). 1989 Jun 10;93(2):46-9.

PMID:2755258
Abstract

The aim of the present study was to evaluate the hemodynamic effects of arginine vasopressin (AVP) infusion in essential hypertension. To this end, 9 hypertensive patients and 10 normotensive controls were evaluated. After one hour rest, AVP was infused at a dosage of 0.5 and 2 ng/(kg/min), in 20 minutes periods. After AVP infusion, mean arterial pressure increased only in hypertensive patients (from 125.8 +/- 7 to 131.8 +/- 7, p less than 0.01 and to 135.6 +/- 6 mmHg, p less than 0.01). Peripheral vascular resistance was significantly increased in both groups during AVP infusion, although the percent increase was higher in hypertensive patients during the last period of infusion (18.3 +/- 10 versus 4.6 +/- 4, p less than 0.05). Cardiac index decreased in both groups during infusion, although this reduction was significantly higher in hypertensive patients than in healthy controls in the last period of infusion (-8.16 +/- 6 versus -1.8 +/- 4%, p less than 0.05). These results confirm that in essential hypertension there is an exaggerated pressor response to AVP infusion, suggesting that it is due to an increased vascular response to this hormone. The compensatory reduction of cardiac output and the inhibition of sympathetic nervous activity mediated through baroreceptor reflexes do not apparently play a role in this pressor response.

摘要

本研究的目的是评估精氨酸加压素(AVP)输注对原发性高血压患者血流动力学的影响。为此,对9名高血压患者和10名血压正常的对照者进行了评估。休息1小时后,以0.5和2 ng/(kg/min)的剂量在20分钟内输注AVP。输注AVP后,仅高血压患者的平均动脉压升高(从125.8±7升至131.8±7,p<0.01,升至135.6±6 mmHg,p<0.01)。在输注AVP期间,两组的外周血管阻力均显著增加,尽管在输注的最后阶段高血压患者的增加百分比更高(18.3±10对4.6±4,p<0.05)。在输注期间两组的心指数均下降,尽管在输注的最后阶段高血压患者的下降幅度明显高于健康对照者(-8.16±6对-1.8±4%,p<0.05)。这些结果证实,在原发性高血压中,对AVP输注存在过度的升压反应,提示这是由于血管对该激素的反应增强所致。心输出量的代偿性降低以及通过压力感受器反射介导的交感神经活动抑制在这种升压反应中显然不起作用。

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