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肾上腺素输注可使健康男性血小板中血栓素B2的生成增加:β-肾上腺素能受体阻滞剂的作用。

Adrenaline infusion evokes increased thromboxane B2 production by platelets in healthy men: the effect of beta-adrenoceptor blockade.

作者信息

Laustiola K, Kaukinen S, Seppälä E, Jokela T, Vapaatalo H

出版信息

Eur J Clin Invest. 1986 Dec;16(6):473-9. doi: 10.1111/j.1365-2362.1986.tb02164.x.

Abstract

The effects of direct adrenergic stimulation, achieved by 60-min adrenaline infusion (0.1-0.2 microgram kg-1 min-1), on thromboxane B2 (TxB2) production by platelets in whole blood ex vivo and on ADP-induced platelet aggregation were studied in seven healthy male volunteers. The effects of two beta-adrenergic blocking agents, pindolol and practolol, on the adrenaline-induced changes were furthermore analyzed. Adrenaline administration resulted in an about ten-fold elevation in plasma adrenaline, and an about three-fold increase in TxB2 production by platelets at 30 min of infusion. The increased TxB2 production persisted throughout the entire adrenaline infusion, and up to 30 min of postinfusion period (recovery). Pindolol blunted markedly the effects of adrenaline on platelet TxB2 production, whereas practolol seemed to have only a weak effect. The sensitivity of platelets to ADP-induced aggregation did not change during the 60 min of adrenaline infusion. However, at 60 min of recovery the platelets showed a significantly increased sensitivity to ADP. Correspondingly, pindolol treatment did not affect platelet sensitivity during the infusion period, but at 60 min of recovery it had caused a significantly decreased sensitivity of platelets to ADP-stimulation. Plasma-free fatty acids increased markedly during the adrenaline infusion. This increase was totally blocked by pindolol, but only partly by practolol. The present results demonstrate that adrenaline, at plasma levels seen for example, in complicated myocardial infarction, stimulates platelet TxB2 production and increases the sensitivity of platelets to ADP after the infusion. Pindolol, but not practolol, inhibits these adrenaline-induced changes in platelet behaviour.

摘要

在7名健康男性志愿者中,研究了通过60分钟输注肾上腺素(0.1 - 0.2微克/千克体重/分钟)实现的直接肾上腺素能刺激对离体全血中血小板血栓素B2(TxB2)生成以及对ADP诱导的血小板聚集的影响。此外,还分析了两种β - 肾上腺素能阻滞剂吲哚洛尔和普拉洛尔对肾上腺素诱导变化的影响。给予肾上腺素导致血浆肾上腺素升高约10倍,输注30分钟时血小板TxB2生成增加约3倍。TxB2生成的增加在整个肾上腺素输注过程中持续存在,并持续到输注后30分钟(恢复阶段)。吲哚洛尔显著减弱了肾上腺素对血小板TxB2生成的影响,而普拉洛尔似乎只有微弱作用。在肾上腺素输注的60分钟内,血小板对ADP诱导聚集的敏感性没有变化。然而,在恢复60分钟时,血小板对ADP的敏感性显著增加。相应地,吲哚洛尔治疗在输注期间不影响血小板敏感性,但在恢复60分钟时,它导致血小板对ADP刺激的敏感性显著降低。在肾上腺素输注期间,血浆游离脂肪酸显著增加。这种增加被吲哚洛尔完全阻断,但仅被普拉洛尔部分阻断。目前的结果表明,例如在复杂心肌梗死中所见血浆水平的肾上腺素,刺激血小板TxB2生成,并在输注后增加血小板对ADP的敏感性。吲哚洛尔而非普拉洛尔抑制这些肾上腺素诱导的血小板行为变化。

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